Late coronary artery stenosis regression within the gianturco-roubin intracoronary stent

• Published in: The American journal of cardiology Vol. 77; no. 4; pp. 247 - 251
• Main Authors: Hermiller, James B., Fry, Edward T., Peters, Thomas F., Orr, Charles M., Van Tassel, James, Waller, Bruce, Pinkerton, Cass A.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-02-1996; Elsevier; Elsevier Limited
• Subjects: Angioplasty; Angioplasty, Balloon, Coronary; Biological and medical sciences; Constriction, Pathologic - diagnostic imaging; Constriction, Pathologic - therapy; Coronary Angiography; Coronary Disease - diagnostic imaging; Coronary Disease - therapy; Coronary Vessels; Diseases of the cardiovascular system; Female; Follow-Up Studies; Humans; Linear Models; Male; Medical research; Medical sciences; Middle Aged; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Recurrence; Stents; Human; Restenosis; Endoprosthesis; Treatment; Radiodiagnosis; Angiography; Follow up study; Coronary artery; Instrumentation therapy; Complication; Instrumental dilatation
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/S0002-9149(97)89387-3

The late angiographic outcome of the Gianturco-Roubin intracoronary stent has not been well defined. To investigate serial changes within the stent, we studied 23 patients (15 men and 8 women, median age 63) who had late angiographic follow-up (>1 year) after undergoing Gianturco-Roubin stenting for angioplasty-associated acute or threatened native coronary artery closure. Coronary angiography before and after stenting, at 6-month follow-up, and at late return was analyzed with quantitative coronary angiography. The median time from stent deployment to late angiographic follow-up was 27 months. As expected, stenting significantly increased the median minimal lumen diameter (MLD) acutely from 1.0 to 2.46 mm. Median percent diameter stenosis decreased from 66% to 18%. Although at 6 months there was a significant loss of the acute gain (median MLD decreased from 2.46 to 1.9 mm), with a corresponding increase in percent stenosis from 18% to 31%, late angiography demonstrated lesion regression, median MLD increasing from 1.9 to 2.15 mm (p = 0.004), and percent stenosis decreasing from 31% to 21% (p = 0.0026). No patient had a significant decline in minimal lesion diameter, and 5 patients had a >50% increase in MID at late follow-up. Linear regression analysis of 6-month MLD and late lumen gain suggested that lesions with the greatest regression were those with the lowest lumen diameters at 6-month angiography. Late angiographic analysis demonstrated significant lesion regression within the Gianturco-Roubin stent, which was sometimes dramatic. In suggesting that coronary arteriography at 6 months may underestimate the late angiographic benefit of intracoronary stenting, these data have important clinical implications, and imply that patients with a stable clinical course and angiographic stent restenosis may often be followed rather than routinely redilated.