| Provisional versus routine coronary stenting. A review. | |
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MedLine Citation:
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PMID: 11733735 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Coronary stenting is the most commonly used coronary revascularization procedure due to the ease of use, safety and evidence that it has predictably better results in several coronary lesion subsets than balloon angioplasty alone. As opposed to routinely stenting all the stentable coronary lesions, in the provisional stenting approach, all the lesions would first be optimally angioplastied and a stent used only in the patients who would not have as good an outcome with balloon angioplasty alone. There are several theoretical advantages to this approach. The two different approaches are compared in this review. Retrospective studies and studies using immediate vessel recoil after optimal balloon angioplasty seemed to suggest that stent-like results after balloon angioplasty had similar target revascularization rates as stenting. However, a prospective randomized study primarily using angiography to guide provisional stenting suggests better outcome in the routine stenting strategy. If provisional stenting were to have similar long-term results as routine stenting, it has to be guided by techniques other than coronary angiography like coronary flow reserve or intravascular ultrasound. Even then, over half of the balloon angioplasty group will need stenting. Besides, based on prospective randomized studies, this strategy is not economically more attractive than the routine stenting strategy. Therefore routine stenting strategy is justifiable for most operators who use coronary angiography to guide their interventions. With further advancement in the stent technology like drug coating routine stenting may be even further attractive. |
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Authors:
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S Khanal; W D Weaver |
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Publication Detail:
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Type: Comparative Study; Journal Article; Review |
Journal Detail:
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Title: Minerva cardioangiologica Volume: 49 ISSN: 0026-4725 ISO Abbreviation: Minerva Cardioangiol Publication Date: 2001 Dec |
Date Detail:
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Created Date: 2001-12-04 Completed Date: 2002-07-31 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0400725 Medline TA: Minerva Cardioangiol Country: Italy |
Other Details:
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Languages: eng Pagination: 395-401 Citation Subset: IM |
Affiliation:
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Henry Ford Heart and Vascular Institute, Detroit, Michigan, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Humans Myocardial Revascularization / instrumentation* Stents* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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