Document Detail

Early angiographic changes of side branches arising from a Palmaz-Schatz stented coronary segment: results and clinical implications.
MedLine Citation:
PMID:  8106696     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The purpose of this study was to assess the effects and clinical implications of Palmaz-Schatz stent implantation on coronary blood flow in side branches arising from a stented coronary artery segment. BACKGROUND: The occlusion of a side branch is a well defined risk after balloon angioplasty. However, the impact of stenting on the coronary flow in side branches arising within the stented segment is unknown. METHODS: Forty-six stented coronary artery segments with 79 side branches emerging from the stented segment were analyzed. Angiographic studies were performed before angioplasty, after balloon dilation, immediately after stenting and 24 h later. Side branches were classified as follows: type A (> or = 1 mm in diameter, with ostial narrowing), type B (> or = 1 mm in diameter, without ostial narrowing), type C (< 1 mm in diameter, with ostial narrowing) and type D (< 1 mm in diameter, without ostial narrowing). Quantitative angiography was used to assess the diameter of the side branches. RESULTS: Stents were implanted electively in lesions with restenosis (41 stents, 89%) or with a suboptimal result after angioplasty (5 stents, 11%). Nine side branches (11%) were type A, 25 (32%) type B, 7 (9%) type C and 38 (48%) type D. At baseline, 68 side branches had Thrombolysis in Myocardial Infarction (TIMI) trial flow grade 3; 10 had grade 2; and 1 had grade 1. Flow worsened (TIMI grade > or = 1) in six side branches (8%) after balloon dilation and in four side branches (5%) after stenting. One additional side branch (1%) was occluded at 24 h. Of the 34 side branches > or = 1 mm in diameter (mean diameter 1.5 +/- 0.3 mm), 2 (6%) had flow impairment after stenting. Three patients experienced transient angina, but no acute myocardial infarction occurred as a result of a side branch occlusion. CONCLUSIONS: Coronary artery stenting does not modify anterograde flow in 90% of side branches. Coronary flow is reduced after stenting in a few branches, but this does not appear to have major clinical relevance.
A I?iguez; C Macaya; F Alfonso; J Goicolea; R Hernandez; P Zarco
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  23     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1994 Mar 
Date Detail:
Created Date:  1994-03-24     Completed Date:  1994-03-24     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  911-5     Citation Subset:  AIM; IM    
Cardiopulmonary Department, Hospital Universitario San Carlos, Madrid, Spain.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary
Constriction, Pathologic / etiology
Coronary Angiography
Coronary Circulation*
Coronary Disease / etiology,  physiopathology,  radiography,  therapy*
Coronary Vessels / pathology
Middle Aged
Prospective Studies
Stents / adverse effects*

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