Document Detail


Utilization of the coronary balloon-expandable coil stent without anticoagulation or intravascular ultrasound.
MedLine Citation:
PMID:  8635259     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The balloon-expandable coil stent has been proved effective in the management of acute and threatened closure after coronary balloon angioplasty and has been shown to reduce restenosis in patients with suboptimal results after coronary balloon angioplasty. Coronary artery stenting has been limited by the occurrence of stent thrombosis and comorbidity related to anticoagulation. This study was undertaken to determine whether anticoagulation may be removed from poststenting protocols, thus reducing comorbidity without increasing stent thrombosis. METHODS AND RESULTS: Between September 1994 and May 1995, 369 patients received balloon-expandable coil stents in native coronary arteries at our institution. Of these patients, 216 were selected for a protocol of aspirin and ticlopidine (for 1 month) without anticoagulation. Eligibility for this protocol followed satisfaction of certain procedural and angiographic criteria. These criteria included adequate coverage of intimal dissections, absence of residual filling defects, and normal (TIMI grade 3) flow in the stented vessel after high-pressure balloon inflations. Intravascular ultrasound was not used to guide stent deployment. The stenting procedure was planned in 37% of patients and unplanned in 63% of patients, including 25 (12%) for acute or threatened closure. During the 30-day follow-up period, stent thrombosis occurred in 2 patients (0.9%), there was 1 death (0.5%), and 2 patients (0.9%) underwent coronary bypass surgery. Vascular access-site complications occurred in 4 patients (1.9%), and bleeding that required blood transfusion occurred in 4 patients (1.9%). CONCLUSIONS: Patients who receive the coronary balloon-expandable coil stent with optimal angiographic results without intravascular ultrasound guidance can be managed safely with a combination of aspirin and ticlopidine without anticoagulation.
Authors:
C M Goods; K F Al-Shaibi; S S Yadav; M W Liu; B H Negus; S S Iyer; L S Dean; S P Jain; W A Baxley; J M Parks; R J Sutor; G S Roubin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation     Volume:  93     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1996 May 
Date Detail:
Created Date:  1996-07-11     Completed Date:  1996-07-11     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1803-8     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiovascular Diseases, University of Alabama at Birmingham, 35294, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects*
Anticoagulants / therapeutic use
Coronary Angiography
Coronary Vessels / ultrasonography
Female
Humans
Male
Middle Aged
Prospective Studies
Stents* / adverse effects
Ticlopidine / adverse effects,  therapeutic use
Chemical
Reg. No./Substance:
0/Anticoagulants; 55142-85-3/Ticlopidine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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