Risultati clinici ed angiografici immediati ed a lungo termine dello stent Wiktor nel trattamento delle occlusioni coronariche croniche

Translated title of the contribution: Short- and long-term results of intracoronary Wiktor stent implantation in chronic total coronary occlusion

Angelo Anzuini, Salvatore Rosanio, Victor Legrand, Monica Tocchi, Renato Coppi, Giuseppe Marazzi, Gabriele Vicedomini, Paolo Pagnotta, Matteo Montorfano, Hans Bonnier, Imad Sheiban, Henri E. Kulbertus, Sergio L. Chierchia

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Percutaneous transluminal coronary angioplasty (PTCA) of chronic total coronary artery occlusions is associated with very high restenosis and reocclusion rates. Coronary stenting has been proposed as a means of improving outcome. However, the Wiktor device for chronic coronary occlusion has never been tested in a large patient sample. This study reports the first multicenter experience with the Wiktor stent for treatment of chronic occlusions. METHODS. From January 1993 to December 1996, 89 consecutive patients with 91 chronic occlusions underwent Wiktor stent implantation after successful PTCA. Post-stenting regimen consisted of coumadin plus aspirin in the first 49 (55%) patients and aspirin plus ticlopidine in the following 40 (45%). RESULTS. Stenting was successful in 87 (98%) patients. At 1 month, 6% of patients had subacute stent thrombosis, 1% access-site complications and 3% major bleeding events. Stent thrombosis showed a univariate association with coumadin therapy (p = 0.009). Angiographic follow-up was obtained in 93% of 82 eligible patients. Restenosis rate was 32%, including 4% reocclusions. Through multiple logistic regression analysis, restenosis was independently associated with multiple stents (odds ratio - OR = 27.67, 95% confidence interval - CI = 4.25 to 79.95, p = 0.0008) and increasing values of occlusion length (OR = 1.23, 95% CI = 1.09 to 1.39, p = 0.001). Freedom from death, myocardial infarction or stented vessel revascularization was 87 and 72% at one and three years, respectively. CONCLUSIONS. Short and long-term clinical and angiographic outcomes are favorable in patients undergoing Wiktor stent implantation for chronic coronary occlusion. Further technical refinements are needed to reduce restenosis rate in patients with long lesions and multiple stents.

Original languageItalian
Pages (from-to)881-891
Number of pages11
JournalGiornale Italiano di Cardiologia
Volume27
Issue number9
Publication statusPublished - Sep 1997

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Coronary Occlusion
Stents
Coronary Balloon Angioplasty
Warfarin
Aspirin
Thrombosis
Ticlopidine
Coronary Vessels
Logistic Models
Odds Ratio
Myocardial Infarction
Regression Analysis
Confidence Intervals
Hemorrhage
Equipment and Supplies
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Risultati clinici ed angiografici immediati ed a lungo termine dello stent Wiktor nel trattamento delle occlusioni coronariche croniche. / Anzuini, Angelo; Rosanio, Salvatore; Legrand, Victor; Tocchi, Monica; Coppi, Renato; Marazzi, Giuseppe; Vicedomini, Gabriele; Pagnotta, Paolo; Montorfano, Matteo; Bonnier, Hans; Sheiban, Imad; Kulbertus, Henri E.; Chierchia, Sergio L.

In: Giornale Italiano di Cardiologia, Vol. 27, No. 9, 09.1997, p. 881-891.

Research output: Contribution to journalArticle

Anzuini, A, Rosanio, S, Legrand, V, Tocchi, M, Coppi, R, Marazzi, G, Vicedomini, G, Pagnotta, P, Montorfano, M, Bonnier, H, Sheiban, I, Kulbertus, HE & Chierchia, SL 1997, 'Risultati clinici ed angiografici immediati ed a lungo termine dello stent Wiktor nel trattamento delle occlusioni coronariche croniche', Giornale Italiano di Cardiologia, vol. 27, no. 9, pp. 881-891.
Anzuini, Angelo ; Rosanio, Salvatore ; Legrand, Victor ; Tocchi, Monica ; Coppi, Renato ; Marazzi, Giuseppe ; Vicedomini, Gabriele ; Pagnotta, Paolo ; Montorfano, Matteo ; Bonnier, Hans ; Sheiban, Imad ; Kulbertus, Henri E. ; Chierchia, Sergio L. / Risultati clinici ed angiografici immediati ed a lungo termine dello stent Wiktor nel trattamento delle occlusioni coronariche croniche. In: Giornale Italiano di Cardiologia. 1997 ; Vol. 27, No. 9. pp. 881-891.
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title = "Risultati clinici ed angiografici immediati ed a lungo termine dello stent Wiktor nel trattamento delle occlusioni coronariche croniche",
abstract = "Background: Percutaneous transluminal coronary angioplasty (PTCA) of chronic total coronary artery occlusions is associated with very high restenosis and reocclusion rates. Coronary stenting has been proposed as a means of improving outcome. However, the Wiktor device for chronic coronary occlusion has never been tested in a large patient sample. This study reports the first multicenter experience with the Wiktor stent for treatment of chronic occlusions. METHODS. From January 1993 to December 1996, 89 consecutive patients with 91 chronic occlusions underwent Wiktor stent implantation after successful PTCA. Post-stenting regimen consisted of coumadin plus aspirin in the first 49 (55{\%}) patients and aspirin plus ticlopidine in the following 40 (45{\%}). RESULTS. Stenting was successful in 87 (98{\%}) patients. At 1 month, 6{\%} of patients had subacute stent thrombosis, 1{\%} access-site complications and 3{\%} major bleeding events. Stent thrombosis showed a univariate association with coumadin therapy (p = 0.009). Angiographic follow-up was obtained in 93{\%} of 82 eligible patients. Restenosis rate was 32{\%}, including 4{\%} reocclusions. Through multiple logistic regression analysis, restenosis was independently associated with multiple stents (odds ratio - OR = 27.67, 95{\%} confidence interval - CI = 4.25 to 79.95, p = 0.0008) and increasing values of occlusion length (OR = 1.23, 95{\%} CI = 1.09 to 1.39, p = 0.001). Freedom from death, myocardial infarction or stented vessel revascularization was 87 and 72{\%} at one and three years, respectively. CONCLUSIONS. Short and long-term clinical and angiographic outcomes are favorable in patients undergoing Wiktor stent implantation for chronic coronary occlusion. Further technical refinements are needed to reduce restenosis rate in patients with long lesions and multiple stents.",
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author = "Angelo Anzuini and Salvatore Rosanio and Victor Legrand and Monica Tocchi and Renato Coppi and Giuseppe Marazzi and Gabriele Vicedomini and Paolo Pagnotta and Matteo Montorfano and Hans Bonnier and Imad Sheiban and Kulbertus, {Henri E.} and Chierchia, {Sergio L.}",
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AU - Anzuini, Angelo

AU - Rosanio, Salvatore

AU - Legrand, Victor

AU - Tocchi, Monica

AU - Coppi, Renato

AU - Marazzi, Giuseppe

AU - Vicedomini, Gabriele

AU - Pagnotta, Paolo

AU - Montorfano, Matteo

AU - Bonnier, Hans

AU - Sheiban, Imad

AU - Kulbertus, Henri E.

AU - Chierchia, Sergio L.

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N2 - Background: Percutaneous transluminal coronary angioplasty (PTCA) of chronic total coronary artery occlusions is associated with very high restenosis and reocclusion rates. Coronary stenting has been proposed as a means of improving outcome. However, the Wiktor device for chronic coronary occlusion has never been tested in a large patient sample. This study reports the first multicenter experience with the Wiktor stent for treatment of chronic occlusions. METHODS. From January 1993 to December 1996, 89 consecutive patients with 91 chronic occlusions underwent Wiktor stent implantation after successful PTCA. Post-stenting regimen consisted of coumadin plus aspirin in the first 49 (55%) patients and aspirin plus ticlopidine in the following 40 (45%). RESULTS. Stenting was successful in 87 (98%) patients. At 1 month, 6% of patients had subacute stent thrombosis, 1% access-site complications and 3% major bleeding events. Stent thrombosis showed a univariate association with coumadin therapy (p = 0.009). Angiographic follow-up was obtained in 93% of 82 eligible patients. Restenosis rate was 32%, including 4% reocclusions. Through multiple logistic regression analysis, restenosis was independently associated with multiple stents (odds ratio - OR = 27.67, 95% confidence interval - CI = 4.25 to 79.95, p = 0.0008) and increasing values of occlusion length (OR = 1.23, 95% CI = 1.09 to 1.39, p = 0.001). Freedom from death, myocardial infarction or stented vessel revascularization was 87 and 72% at one and three years, respectively. CONCLUSIONS. Short and long-term clinical and angiographic outcomes are favorable in patients undergoing Wiktor stent implantation for chronic coronary occlusion. Further technical refinements are needed to reduce restenosis rate in patients with long lesions and multiple stents.

AB - Background: Percutaneous transluminal coronary angioplasty (PTCA) of chronic total coronary artery occlusions is associated with very high restenosis and reocclusion rates. Coronary stenting has been proposed as a means of improving outcome. However, the Wiktor device for chronic coronary occlusion has never been tested in a large patient sample. This study reports the first multicenter experience with the Wiktor stent for treatment of chronic occlusions. METHODS. From January 1993 to December 1996, 89 consecutive patients with 91 chronic occlusions underwent Wiktor stent implantation after successful PTCA. Post-stenting regimen consisted of coumadin plus aspirin in the first 49 (55%) patients and aspirin plus ticlopidine in the following 40 (45%). RESULTS. Stenting was successful in 87 (98%) patients. At 1 month, 6% of patients had subacute stent thrombosis, 1% access-site complications and 3% major bleeding events. Stent thrombosis showed a univariate association with coumadin therapy (p = 0.009). Angiographic follow-up was obtained in 93% of 82 eligible patients. Restenosis rate was 32%, including 4% reocclusions. Through multiple logistic regression analysis, restenosis was independently associated with multiple stents (odds ratio - OR = 27.67, 95% confidence interval - CI = 4.25 to 79.95, p = 0.0008) and increasing values of occlusion length (OR = 1.23, 95% CI = 1.09 to 1.39, p = 0.001). Freedom from death, myocardial infarction or stented vessel revascularization was 87 and 72% at one and three years, respectively. CONCLUSIONS. Short and long-term clinical and angiographic outcomes are favorable in patients undergoing Wiktor stent implantation for chronic coronary occlusion. Further technical refinements are needed to reduce restenosis rate in patients with long lesions and multiple stents.

KW - Anticoagulation

KW - Coronary artery occlusion

KW - Coronary stent

KW - Restenosis

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