Comparison of Early Outcome in Patients Undergoing Intracoronary Stent Implantation with Either Conventional or New Approach

Intracoronary stent implantation has been shown to reduce restenosis in comparison to balloon angioplasty but stent thrombosis and bleeding complications related to anticoagulation are comtinuing to be major limitations of this method. Recently, low complication rate has been reported with optimal stent implantation by using final balloon dilatations with high pressure and therapy with aspirin + ticlopidine. In this study we investigated the early outcome in 42 patients undergoing intracoronary stent implantation with the new approach and we compared them with 46 patients who underwent stent placement with the conventional approach. In the first group who did not undergo final balloon dilatations with high pressure and who received anticoagulant therapy, clinical success was 80 %, stent thrombosis 13%, death 2.2%, Q wave myocardial infarction 4.3%, non-Q myocardial infarction 4.3%, and groin complications 8.6%. In the second group who underwent final high-pressure balloon dilatations and were treated with combined antiplatelet therapy clinical success was 100% and there was no major complication. Ticlopidine-related leukopenia occurred in one patient (2.3%) and liver enzyme elevation in another (2.3%). Clinical success and stent thrombosis rates were significantly different between the two groups (p<0.05). In conclusion, final high-pressure balloon dilatation after the stent deployment and therapy with two antiplatelet agents appear to allow to obtain low complication and high clinical success rate.