Abstract
Outside the United States, Palmaz-Schatz coronary stents are implanted by hand-crimping the stent to a high pressure balloon without the use of a protective sheath. This lowers the delivery profile, increases the ease of deployment, and ensures that the postdilatation balloon is centered on the stent. To assess this bare stenting technique, 209 patients were retrospectively analyzed: 92 patients (107 lesions) with the sheath protected stent delivery system (SDS) and 117 patients (150 lesions) with the bare stent approach. The number of balloons used per lesion in the bare stent group was significantly less than in the SDS group (1.9 +/- 0.6 vs. 3.8 +/- 1.2, P < 0.0001). In addition, the procedure time in the bare stent group was significantly shorter than in the SDS group (106 +/- 55 vs. 134 +/- 60 min, P = 0.001). There was no difference in frequency of adverse events or stent displacement during the procedure. The bare stenting technique decreases the procedure time, reduces the number of balloons used, and is as safe as the SDS approach.
Highlights
In recent years, a variety of intracoronary stents has been developed that offer a valuable nonsurgical approach to the management of acute complications of failed angioplasty and to reduce restenosis compared with percutaneous transluminal coronary angioplasty [1,2]
PTCA for acute myocardial infarction was more frequent in the bare stent group than in the stent delivery system (SDS) group (25% vs. 13%, P Ͻ 0.05)
Even if the balloon used with the SDS is discounted, the mean number of balloons used per lesion in the bare stent group was significantly less than in the SDS group (1.9 Ϯ 0.6 vs. 2.4 Ϯ 0.7, P Ͻ 0.0001)
Summary
A variety of intracoronary stents has been developed that offer a valuable nonsurgical approach to the management of acute complications of failed angioplasty and to reduce restenosis compared with percutaneous transluminal coronary angioplasty [1,2]. The most commonly used stent system in the United States is the Palmaz-Schatz coronary stent (Cordis, a Johnson & Johnson Company, Miami Lake, FL). Outside the United States, to overcome these drawbacks, the majority of Palmaz-Schatz stents are implanted by hand-crimping the stent to a high pressure balloon without the use of a protective sheath [3,4]. This lowers the delivery profile, increases the ease of deployment, and ensures that the postdilatation balloon is centered on the stent.
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