Comparison of results of intracoronary implantation of the Palmaz-Schatz stent with conventional balloon angioplasty in chronic total coronary arterial occlusion

Abstract

We compared angiographic and clinical outcomes after successful revascularization of chronic total coronary arterial occlusion with the placement of the Palmaz-Schatz stent (43 patients) and conventional balloon angioplasty (53 patients). After the procedure, the coronary stent led to a greater minimal lumen diameter than conventional balloon angioplasty (2.6 vs 1.7 mm, p < 0.001), resulting in a smaller residual stenosis (6.5% vs 36.7%, p < 0.001). At 6-month follow-up, there was no significant difference in late loss between the groups, resulting in a larger minimal lumen diameter at follow-up in the stent group (1.8 vs 1.1 mm, p < 0.001). The incidence of restenosis was lower in the stent group (27.9% vs 56.6%, p < 0.005). The frequency of the combination of myocardial infarction and coronary artery bypass graft surgery tended to be less in the stent group (2.3% vs 11.3%, p = 0.09). Placement of the Palmaz-Schatz stent improved left ventricular ejection fraction by 26% in patients who had reduced left ventricular function (p < 0.05), but conventional balloon angioplasty did not. Thus, placement of the Palmaz-Schatz stent provided a wider lumen than did conventional balloon angioplasty and, therefore, reduced the incidence of restenosis in chronic total coronary arterial occlusion. The lower restenosis rate of coronary stenting would be beneficial for long-term clinical outcome in patients with chronic total occlusion.