CORONARY STENTING WITH THE HALF (DISARTICULATED) PALMAZ-SCHATZ STENT - IMMEDIATE RESULTS AND 6-MONTH FOLLOW-UP

Coronary stenting with the half disarticulated Palmaz-Schatz stent is particularly suitable for ostial stenoses, diaphragm stenoses, stenose s distal to tortuous segments or coronary bends and localized dissecti ons after balloon angioplasty. Nevertheless very few data regarding th e half stent exist and follow-up data are nonexistent. From January of 1994 to December of 1995 a total of 207 half stents were implanted in 175 patients. Most patients had stable or unstable angina and in the majority of cases the stent was implanted due to localized dissection or to suboptimal result. The procedural success rate was 98%. After st ent implantation, 82 patients were treated with acetylsalicylic acid ( ASA) and oral anticoagulant (group A), whereas 93 were treated with AS A and ticlopidine (group a), Seven patients had subacute thrombosis (5 , group A; 2, group B), and six patients had major bleeding (5, group A; 1, group B), Overall, patients in group A had more cardiovascular c omplications than patients in group B (10, group A; 3, group a; p = 0. 047). After 6-mo follow-up, 1 patient had died and 27 patients had sym ptoms of angina (16%). Thirteen patients underwent a second PTCA (7%) and four patients (2%) were referred for coronary artery bypass. In co nclusion, coronary stenting with half Palmaz-Schatz stent appears to b e a safe and effective procedure, In selected cases, the half Palmaz-S chatz stent is easier to handle than the complete stent, it is associa ted with a low rate of clinical restenosis, and it lowers procedural c osts. (C) 1997 Wiley-Liss, Inc.