Efficacy of coronary stenting versus balloon angioplasty in small coronary arteries. Stent Restenosis Study (STRESS) Investigators
| Autor: | M P, Savage, D L, Fischman, R, Rake, M B, Leon, R A, Schatz, I, Penn, M, Nobuyoshi, J, Moses, J, Hirshfeld, R, Heuser, D, Baim, M, Cleman, J, Brinker, S, Gebhardt, S, Goldberg |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Male
Chi-Square Distribution United States Food and Drug Administration Coronary Disease Equipment Design Middle Aged Coronary Angiography Coronary Vessels Disease-Free Survival United States Cohort Studies Survival Rate Treatment Outcome Elective Surgical Procedures Recurrence Linear Models Humans Female Stents Angioplasty Balloon Coronary Follow-Up Studies |
| Zdroj: | Journal of the American College of Cardiology. 31(2) |
| ISSN: | 0735-1097 |
| Popis: | The goal of this study was to compare the efficacy of elective stent implantation and balloon angioplasty for new lesions in small coronary arteries.Palmaz-Schatz stents have been designed and approved by the Food and Drug Administration for use in coronary arteries with diametersor = 3.0 mm. The efficacy of elective stent placement in smaller vessels has not been determined.By quantitative coronary angiography, 331 patients in the Stent Restenosis Study (STRESS) I-II were determined to have a reference vessel3.0 mm in diameter. Of these, 163 patients were randomly assigned to stenting (mean diameter 2.69 +/- 0.21 mm), and 168 patients were assigned to angioplasty (mean diameter 2.64 +/- 0.24 mm). The primary end point was restenosis, defined asor = 50% diameter stenosis at 6-month follow-up angiography. Clinical event rates at 1 year were assessed.Baseline clinical and angiographic characteristics were similar in the two groups. Procedural success was achieved in 100% of patients assigned to stenting and in 92% of patients assigned to angioplasty (p0.001). Abrupt closure within 30 days occurred in 3.6% of patients in both groups. Compared with angioplasty, stenting conferred a significantly larger postprocedural lumen diameter (2.26 vs. 1.80 mm, p0.001) and a larger lumen at 6 months (1.54 vs. 1.27 mm, p0.001). Restenosis (or = 50% diameter stenosis at follow-up) occurred in 34% of patients assigned to stenting and in 55% of patients assigned to angioplasty (p0.001). At 1 year, event-free survival was achieved in 78% of the stent group and in 67% of the angioplasty group (p = 0.019).These findings suggest that elective stent placement provides superior angiographic and clinical outcomes than balloon angioplasty in vessels slightly smaller than 3 mm. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|