[Coronary vascular stent implantation--experiences with the first 100 implants]

Coronary stent implantation was performed for blocking elastin recoil, reducing acute complications and restenosis. In 89 (95%) of 91 patients successful stent implantation was possible. No stent embolization occurred. Coronary luminal diameter measured 1.05 +/- 0.57 before PTCA and 1.9 +/- 0.2 mm post PTCA. After stent implantation mean diameter of the coronary artery measured 3.05 +/- 0.2 mm, with a balloon diameter of 3.0. Thus, elastic recoil is nearly completely blocked. In 28 (31%) of 91 patients stent implantation was performed for acute symptomatic dissection in 27 patients and occlusion in one patient. Stent delivery was successful in all. There was no acute occlusion, one acute thrombosis which could be treated with urokinase, no Q-wave-infarct, 4 (14%) non-Q-wave-infarcts and 14 (20%) CK-elevations without ECG changes. Coronary bypass surgery was necessary in 2 patients on an elective base during follow-up. In 72 (90%) of 80 patients follow-up coronary angiograms after 4 to 6 months were performed. Restenosis rate measured 21% overall, 14% for single stent, 60% for multiple stent implantation, and 14% in bail-out situations. Subacute thrombosis occurred in 10 (12%) of 89 patients, 7 (70%) of 10 events after bail-out stenting. Recanalization by thrombolytic and/or PTCA was possible in 9/10 patients. By improving monitoring of anticoagulation, the subacute thrombosis rate could be reduced to 3% even in bail-out situations. Bleeding complication occurred in 10% of the patients.(ABSTRACT TRUNCATED AT 250 WORDS)