The vascular stent in percutaneous coronary revascularization

Balloon angioplasty is commonly used for coronary revascularization. Coronary stents were introduced to overcome its 2 main limitations: acute coronary occlusion and restenosis. We describe our experience with the use of 27 coronary stents in 26 patients. The indications for stenting were acute or threatened coronary occlusion in 16 patients, in 7 recurrent restenosis, and vein graft narrowing in the rest. Stent deployment was successful in all cases and there was no mortality. The hospital course was complicated by subacute thrombotic occlusion of the stent (2 patients) initially treated by balloon angioplasty, retroperitoneal bleeding (3), and surgical closure of femoral pseudoaneurysm (2); 22 were discharged without complications; 1 patient required coronary bypass. Coronary stenting has a high rate of success and is very effective in cases of abrupt coronary occlusion which would otherwise require emergency surgery. It is probably associated with a lower restenosis rate than standard balloon angioplasty. Accurately monitored anticoagulant therapy is essential to prevent complications.