Immediate and one-year outcome of intracoronary stent implantation in small coronary arteries with 2.5-mm stents

Background The role of coronary stenting in the treatment of stenoses in sm all coronary arteries with use of 2.5-mm stents is not well defined. Methods and Results Between January 1995 and August 1999, 651 patients with stenoses in small coronary arteries were treated with 2.5-mm stents (n = 1 08) or 2.5-mm conventional balloon angioplasty (BA) (n = 543). Patients who received treatment with both 2.5-mm and greater than or equal to3.0-mm ste nt placement or balloons were excluded. Procedural success and complication rates as well as 1-year follow-up outcomes were examined. Baseline clinica l characteristics were similar between the two groups, except patients in t he stent group were more likely to have hypertension and a family history o f coronary artery disease and less likely to have prior myocardial infarcti on. Angiographic success rates were higher in the stent group (97.2% vs 90. 2%, P =.02). In-hospital complication rates were comparable between the two groups. Among successfully treated patients, 1-year follow-up revealed no significant differences in the survival (96.2% vs 95.2%, P =.89) or the fre quency of Q-wave myocardial infarction (0% vs 0.4%, P =.60) or coronary art ery bypass grafting (8.4% vs 6.8%, P =.89) between the stent and BA groups, respectively. However, patients in the stent group were more likely to hav e adverse cardiac events (35.4% vs 22. 1%, P =.05). Stent use after excludi ng GR II stent use, however, was not independently associated with reduced cardiac events at follow-vp (relative risk 1.3 [95% confidence interval 0.8 -2.3], P =.30). Conclusions Intracoronary stent implantation of stenoses in small coronary arteries with 2.5-mm stents can be carried out with high success and accept able complication rates. However, compared with BA alone, stent use was not associated with improved outcome through 1 year of follow-up.