관동맥내 Flexible Coil(Gianturco-Roubin) 스텐트 삽입후 추적혈관 조영 소견

Abstract

Background: Intracoronary stent with various designs have been developed to treat dissections or acute closure after angioplasty. The efficacy of flexible coil stent as a bail-out device has been reported. However, the restenosis after stenting still remained as a main limitation like other devices. This study reports on the angiographic follow-up after successful intracoronary stenting with flexible coil stent.

Method: From April 1993 through July 1994, coronary stenting was tried in 21 patients by a single operator for various indications(acute or threatened closure, suboptimal result after balloon angioplasty). The nineteen(95%) out of 20 patients in whom stent was successfully deployed underwent follow-up coronary angiography 7.6±3.0 months after coronary stenting.

Result: Mean age was 54.7±11.3(33-73) years and 16 parients were men. Clinical diagnosis of patients were as follows : stable angina 7, unstable angina 6, old myocardial infarction with stable angina 6 and acute myocardial infarction in 1 patient, respectively. Stents were implanted at left anterior descending artery in 9, left circumflex artery in 5 and right coronary artery in 8. Ten out of 21 stents(47.6%) were found to be renarrowed more than 50% at follow-up coronary angiography. There was no significant difference in clinical and angiographic variables between restenosis group and no-restenosis group. Coronary artery bypass graft surgery was performed in 1 patient for the treatment of restenosis after stenting. Repeat PTCA was performed in 3 patients and remaining 5 patients were followed medically.

Conclusion: Flexible coil(Gianturco-Roubin) coronary stent is a useful adjunct percutaneous intervention to prevent or minimize complicatioms associated with dissections. Despite favorable initial angiographic and clinical results, 47.6% of stents were found to be renarrowed significantly at follow-up coronary angiography. New techniques or more optimal characters of stents would be desired.