TY - JOUR
T1 - Stents in total occlusion for restenosis prevention
T2 - The multicentre randomized STOP study
AU - Lotan, Chaim
AU - Rozenman, Y.
AU - Hendler, A.
AU - Turgeman, Y.
AU - Ayzenberg, O.
AU - Beyar, R.
AU - Krakover, R.
AU - Rosenfeld, T.
AU - Gotsman, M. S.
PY - 2000
Y1 - 2000
N2 - Aims This multicentre randomized study set out to evaluate whether coronary stenting improves the results of successful balloon angioplasty for chronic total occlusion. Balloon angioplasty for chronic total occlusion has a high restenosis rate. Several reports have suggested that coronary stenting may decrease the likelihood of restenosis and reocclusion. Methods and Results Patients with total coronary artery occlusions who had an optimal PTCA result were randomized either to no further treatment or additional stent implantation. The AVE microstent was used and all patients were scheduled for a 1-, 3-, and 6-month clinical follow-up. Repeat coronary angiography to assess the rate and pattern of restenosis was performed at 6 months or earlier if clinically indicated. Ninety-six patients were enrolled in this study. The mean age was 59.3 ± 10.3 years and 15 were females. Forty-eight patients were randomized to the stent arm, receiving 52 stents (lengths 18-39 mm). Stent implantation was successful in all and there were no major procedure-related complications. Sixty-nine patients (72%) were restudied after 6 months. The binary restenosis rates (50%), in the PTCA arm were 70.9% with a minimal lumen diameter of 1.01 ± 0.79 mm compared to 42.1% in the stent arm with a minimal lumen diameter of 1.63 ± 1.02 mm (P=0.034). Reocclusion occurred in 7.9% in the stent group compared to 16.1% in the PTCA group. Restenosis in the PTCA group was focal in 88% of patients and occurred at the point of total obstruction (within 5 mm), compared to diffuse instent restenosis, which occurred in 54% of the patients in the stent group. Conclusion Coronary stenting can significantly decrease the rate of restenosis and reocclusion of total occlusions. As restenosis in the stent group was more diffuse, care should be taken to implant short stents at the site of occlusion. (C) 2000 The European Society of Cardiology.
AB - Aims This multicentre randomized study set out to evaluate whether coronary stenting improves the results of successful balloon angioplasty for chronic total occlusion. Balloon angioplasty for chronic total occlusion has a high restenosis rate. Several reports have suggested that coronary stenting may decrease the likelihood of restenosis and reocclusion. Methods and Results Patients with total coronary artery occlusions who had an optimal PTCA result were randomized either to no further treatment or additional stent implantation. The AVE microstent was used and all patients were scheduled for a 1-, 3-, and 6-month clinical follow-up. Repeat coronary angiography to assess the rate and pattern of restenosis was performed at 6 months or earlier if clinically indicated. Ninety-six patients were enrolled in this study. The mean age was 59.3 ± 10.3 years and 15 were females. Forty-eight patients were randomized to the stent arm, receiving 52 stents (lengths 18-39 mm). Stent implantation was successful in all and there were no major procedure-related complications. Sixty-nine patients (72%) were restudied after 6 months. The binary restenosis rates (50%), in the PTCA arm were 70.9% with a minimal lumen diameter of 1.01 ± 0.79 mm compared to 42.1% in the stent arm with a minimal lumen diameter of 1.63 ± 1.02 mm (P=0.034). Reocclusion occurred in 7.9% in the stent group compared to 16.1% in the PTCA group. Restenosis in the PTCA group was focal in 88% of patients and occurred at the point of total obstruction (within 5 mm), compared to diffuse instent restenosis, which occurred in 54% of the patients in the stent group. Conclusion Coronary stenting can significantly decrease the rate of restenosis and reocclusion of total occlusions. As restenosis in the stent group was more diffuse, care should be taken to implant short stents at the site of occlusion. (C) 2000 The European Society of Cardiology.
KW - Restenosis
KW - Stents
KW - Total occlusion
UR - http://www.scopus.com/inward/record.url?scp=0033695760&partnerID=8YFLogxK
U2 - 10.1053/euhj.2000.2295
DO - 10.1053/euhj.2000.2295
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C2 - 11071802
AN - SCOPUS:0033695760
SN - 0195-668X
VL - 21
SP - 1960
EP - 1966
JO - European Heart Journal
JF - European Heart Journal
IS - 23
ER -