Long-term Clinical and Angiographic Results of Stenting in Coronary Ostial Lesions

Coronary ostial Jesions are considered unfavorable for percutaneous balloon angiop1asty because of low rate of success and high rate of restenosis. Some technical difficulties exist in stenting of this type of coronary lesions, and data about long-term elinical and angiographic follow up is limited after stenting of ostial coronary lesions. We analyzed the success and complication rates and long-term elinical and angiographic follow up results in 56 patients who underwent coronary stenting for 57 ostial lesions. Ten (17,5%) Iesions were aorto-ostial and 47 (82,5%) were non aorto-ostial (branch and side branch vessel) Jesions. The procedure was unsuccessful in one patient, thus the rate of success was 98,2%. No major cardiac event occurred during in hospital follow-up period. One patient had acute anterior myocardial infaretion 9 days after stenting and treated immediately with tissue-type plasminogen activator (t-PA), and later underwent eleeti ve coronary bypass surgery. Forty-six of the remaining 55(84%) patients had coronary angiography six months after the procedure. Nineteen (41,3%) patients had angiographic restenosis, and 10 (17 ,8%) had repeat PTCA for stent restenosis, 5 (8,6%) needed eleeti ve coronary artery bypass surgery and 4 (7,1 %) treated medically. Six months after stenting, freedom from any cardiac event was 71 ,4%. In conclusion, the procedural success rate is high and angiographic restenosis, target lesion revascularization rates are also high in coronary stenting in our patients with aorto-ostial and nonaorto- ostial Jesions. Since in the literature results of stenting in coronary ostial lesions, are scarce, we need large scale randomized trials comparing the results of different kinds of angioplasty devices in coronary ostial Jesions.