Flexible Coil (Gianturco-Roubin) Coronary Stent의 초기 임상 경험

Abstract

Background and Purpose Abrupt vessel closure and acute ischemia were unpredictable during percutaneous transluminal coronary angioplasty. Abupt or threatened closure after coronary angioplasty is associated with increased risk of myocardial infarction, emergency coronary artery bypass graft surgery and in-hospital mortality. One of major causes of these complications was associated with coronary artery dissection. Intracoronary stent with various designs have been developed to treat dissections or acute closure after angioplasty. This study reports on the early clinical experience with flexible coil stent in a single center.

Method From March 1993 through December 1993, 33 patients underwent coronary stenting with flexible coil stent(12-20mm length, 2.5-3.5mm diameter) for various indications(acute or threatened closure, suboptimal result after balloon angioplasty, elective).

Results Thirty-two flexible coil stent were successfully deployed in 31 patients among 34 attempted stents with 94% of procedural success rate. Intracoronary stenting resulted in an immediate angiographic improvement in the diameter stenosis from 87% before stenting to 18% after stenting by caliper estimation. Emergency coronary artery bypass graft surgery was required in 1 of 33 patients(3%). The incidence of in-hospital myocardial infarction(Q wave and non-Q wave) was 3% (1 of 33 patients.) Complications included blood loss, primarily from the arterial access site in 4 patients, hemopericardium and aspiration pneumonia in 1 patients respectively.

Conclusion Initial experience with flexible coil(Gianturco-Roubin) coronary stent indicates that it is a useful adjunct percutaneous intervention to prevent or minimize complications associated with coronary artery dissection after balloon angioplasty with high technical success rate.