Acute Luminal Gain after Stenting: Comparison of Gianturco-Roubin and Palmaz-Schatz Stents

The Gianturco-Roubin stent has an open coil structure with a clamshell configuration and a relatively large distance between its transversely parallel struts. This stent design results in a low metallic surface area but may possibly also lead to more vessel recoil and less acute luminal gain than that obtained with the more rigid Palmaz-Schatz stent. The present study compares the acute angiographic results obtained with both stents. Quantitative coronary arteriography was performed in 77 patients in whom one of the following was successfully implanted: 1) a Palmaz-Schatz stent (n = 27), 2) a normally sized (n = 25) Gianturco-Roubin stent (n = 25), 3) a one-size oversized Gianturco-Roubin stent (n = 30). Diameter stenosis after stenting was greater in the patients with a normally sized Gianturco-Roubin stent (28 +/- 2%) than in those with a Palmaz-Schatz stent (18 +/- 1.2%, p < 0.05). This difference was in part attributed to a more important acute luminal loss due to elastic recoil and plaque protrusion with Gianturco-Roubin stents (25 +/- 2%) compared with Palmaz-Schatz stents (11 +/- 1.5%, p < 0.0001). However, in the patients with an oversized Gianturco-Roubin stent acute gain was similar to that obtained with Palmaz-Schatz stents (50 +/- 3.2% vs. 48 +/- 3%, p=0.68) and residual stenosis (20 +/- 2%) was less than that with a normally sized Gianturco-Roubin stent (p < 0.05). In the patients with an oversized Gianturco-Roubin stent the actual size during deployment (109 +/- 2.9% of the reference diameter) was smaller than the nominal size (122 +/- 1.7%). Thus, one-size oversizing of the Gianturco-Roubin stent corrects for the smaller actual than nominal diameter of this stent. It also compensates for the greater recoil observed with this stent and leads to similar acute diameter gain as that obtained with a Palmaz-Schatz stent without causing an excessive coronary artery stretching.