Intracoronary stenting without anticoagulation accomplished with intravascular ultrasound guidance

Background: The placement of stents in coronary arteries has been shown to reduce restenosis in comparison to balloon angioplasty. However, clinical use of intracoronary stents is impeded by the risk of subacute stent thrombosis and complications associated with the anticoagulant regimen. To reduce these complications, the hypothesis that systemic anticoagulation is not necessary when adequate stent expansion is achieved was prospectively evaluated on a consecutive series of patients who received intracoronary stents. Methods and Results: From March 1993 to January 1994, 359 patients underwent Palmaz- Schatz coronary stent insertion. After an initial successful angiographic result with