Coronary Artery DiseaseComparison of Aggressive Versus Nonaggressive Balloon Dilatation for Stent Deployment on Late Loss and Restenosis in Native Coronary Arteries
Section snippets
Patients:
This study includes 649 consecutive patients undergoing stenting of 688 narrowings between May 1991 and June 1994. Baseline and follow-up clinical data as well as lesion and procedural characteristics were prospectively entered into a dedicated database (Filemaker Pro, Claris Corporation, Santa Clara, California). Patients were routinely seen or contacted at 6 months and encouraged to have follow-up angiography.
Patient Groups:
During the time period of this series of patients information from ultrasound
Baseline Characteristics:
Baseline clinical characteristics are displayed in Table I. Palmaz-Schatz stents (Johnson & Johnson Interventional Systems, Warren, New Jersey) were used in 91% of narrowings, including all lesions in group A (before 1993). Fourteen percent of lesions in group B (1993 and afterward) did not receive Palmaz-Schatz stents, but had only other stent types including Wiktor (Medtronic Interventional, San Diego, California), Microstent (AVE, Applied Vascular Engineering, Santa Rosa, California), and
Discussion
Information from intravascular ultrasound has demonstrated that stents are frequently underdeployed despite acceptable angiographic results,2, 12, 13, 14which has led to the use of aggressive techniques to more fully expand the stents. This change in strategy has contributed to lower rates of stent thrombosis and the abandonment of anticoagulant therapy in favor of antiplatelet agents. There have been concerns that the increased barotrauma of aggressive stent deployment techniques might lead to
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