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 language | Italian |
|---|---|
| Pages (from-to) | 881-891 |
| Number of pages | 11 |
| Journal | Giornale Italiano di Cardiologia |
| Volume | 27 |
| Issue number | 9 |
| Publication status | Published - Sep 1997 |
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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 journal › Article
}
TY - JOUR
T1 - Risultati clinici ed angiografici immediati ed a lungo termine dello stent Wiktor nel trattamento delle occlusioni coronariche croniche
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.
PY - 1997/9
Y1 - 1997/9
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
UR - http://www.scopus.com/inward/record.url?scp=9844245887&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=9844245887&partnerID=8YFLogxK
M3 - Articolo
C2 - 9378193
AN - SCOPUS:9844245887
VL - 27
SP - 881
EP - 891
JO - Giornale Italiano di Cardiologia
JF - Giornale Italiano di Cardiologia
SN - 0046-5968
IS - 9
ER -