902-6 A Prospective Study of Gianturco-Roubin Coronary Stent Implantation without Anticoagulation

Abstract

The Gianturco Roubin (GR) coronary stent has been implanted in 91 lesions in 78 patients. The indications for stent implantation were 41 elective (45%), 17 chronic total occlusion (19%), 10 acute occlusion (11%), 9 threatened closure (10%), 8 restenosis (9%) and 6 suboptimal PTCA (7%). Vessel distribution was 50 LAD (55%), 21 RCA (23%). 18 LCX (20%) and 2 SVG (2%). Successful stent implantation was achieved in 72 patients (92%). Average GR stent per lesion was 1.4 ± 0.5 (range 1 to 3). More than 1 stent was used in 44 patients (61%). Lesion length was 16.3 ± 9.1 mm. Final balloon/vessel ration was 1.17 ± 0.15. Maximum inflation pressure was 16 ± 3 atmospheres. An addi ± l stent inside the GR stent was required in 5 lesions (6%) to reinforce plaque prolapse. A Palmaz-Schatz used in 4 lesions and a GR in 1 lesion. After stent implantation with intravascular ultrasound guidance, 60 patients (83%) with 71 lesions (82%) were treated only with antiplatelet therapy without anticoagulation. Procedure related major complication included 3 emergency CABG (4%) and one death (1%). To date, 35 of an eligible 54 lesions (64%). received 4–6 months angiographic follow up (F/U). Quantitative angiographic measurements are summarized in the table below: AG results Reference (mm) Lesion (mml % stenosis Baseline 2.97 ± 0.49 0.85 ± 0.67 72 ± 20 Post stent 3.00 ± 0.47 2.79 ± 0.52 6 ± 17 F/U 2.96 ± 0.57 1.78 ± 0.96 38 ± 32 The majority of patients were treated with only antiplatelet therapy after successful stent implantation. There was no stent thrombosis or vascular complications. The GR coronary stent restenosis rate by ≥ 50% diameter stenosis was 32% (n = 11 lesions). Conclusions. (1) When optimal GR stent expansion was achieved, there was no stent thrombosis despite the absence of anticoagulation in the majority of patients. (2) In the cases with plaque prolapse, overlapping stents were an effective method to reinforce lumen support. (31 The restenosis rate after Gianturco Roubin stent implantation is favorable when considering the high incidence of bailout procedures, long lesion length and small reference vessel diameter of this cohort.