Management of restenosis within the Palmaz-Schatz coronary stent (the U.S. multicenter experience)

• Published in: The American journal of cardiology Vol. 71; no. 4; pp. 364 - 366
• Main Authors: Baim, Donald S., Levine, Marc J., Leon, Martin B., Levine, Sally, Ellis, Steven G., Schatz, Richard A., The U.S. Palmaz-Schatz Stent Investigators
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.02.1993; Elsevier
• Subjects: Biological and medical sciences; Diseases of the cardiovascular system; Medical sciences; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Human; Restenosis; Endoprosthesis; Coronary artery; Instrumentation therapy; Cardiovascular disease; Complication; Instrumental dilatation; Coronary heart disease
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/0002-9149(93)90813-R

Coronary stenting was introduced in the hope of improving both the short- and long-term results of conventional balloon angioplasty. 1 Nearly 2,000 patients have been treated with the balloon expandable Palmaz-Schatz stent in the United States since 1988, with a 98% acute placement success and minimal residual stenosis. 2 Acute closure of the stent has been rare, but subacute thrombotic occlusion has been reported within the first several weeks after stent placement in almost 3% of patients, despite an anticoagulant program including aspirin, dipyridamole and Coumadin ™. The incidence of subsequent restenosis varies with the size, location and number of stents placed, but ≥20% of successfully stented patients show angiographic evidence of restenosis 6 months after stent placement. 3,4 Despite the well-recognized incidence of in-stent restenosis, however, there have been no formal reports outlining how this type of lesion responds to various management alternatives — in particular to repeat dilatation.