Clinical experience with the palmaz-schatz coronary stent: Initial results of a multicenter study

Richard A. Schatz, Donald S. Baim, Martin Leon, Stephen G. Ellis, Sheldon Goldberg, John W. Hirshfeld, Michael W. Cleman, Henry S. Cabin, Craig Walker, Jody Stagg, Maurice Buchbinder, Paul S. Teirstein, Eric J. Topol, Michael Savage, Jose A. Ferez, R. Charles Curry, Hall Whitworth, J. Eduardo Sousa, Fermin Tio, Yaron AlmagorRegina Ponder, Ian M. Penn, Brad Leonard, Sally L. Levine, R. David Fish, Julio C. Palmaz

Research output: Contribution to journalArticle

545 Scopus citations

Abstract

Stenting of native coronary arteries with a balloon-expandable stent was attempted in 226 patients after elective angioplasty. Delivery of the device was successful in 213 (94%) of the patients. Of these, 39 received aspirin and dipyridamole only (group 1) and 174 received aspirin, dipyridamole, and warfarin for 1-3 months (group 2). There was no abrupt closure (≤1 day) or perioperative death in either group. In-hospital or perioperative complications in group 1 compared with group 2 were as follows: subacute closure (1-14 days), seven (18%) patients versus one (0.6%) patient, respectively, p<0.0001; myocardial infarction, five (13%) patients versus one (0.6%) patient, respectively; condition requiring urgent bypass surgery, one (2.5%) patient versus no patients, respectively. Thus, the incidence of major complications such as death, myocardial infarction, or a condition requiring urgent bypass surgery was 15% in group 1 and 0.6% in group 2. Clinical follow-up revealed that 92% of the patients were asymptomatic at 3 months after stenting compared with 6% before stenting (p<0.0001). Of the 13 patients who were symptomatic, nine underwent cardiac catheterization and, ultimately, successful elective coronary angioplasty or bypass surgery. We conclude that a high delivery success rate can be expected with this device and that clinical thrombosis is less frequent in anticoagulated patients than in nonanticoagulated patients. Furthermore, in this selected patient population, coronary stenting results in a low incidence of in-hospital and perioperative complications. Clinical success, defined by absence of symptoms, appears to be sustained at 3 months.

Original languageEnglish (US)
Pages (from-to)148-161
Number of pages14
JournalCirculation
Volume83
Issue number1
DOIs
StatePublished - 1991

Keywords

  • Complications
  • Coronary angioplasty
  • Coronary artery disease
  • Stents

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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    Schatz, R. A., Baim, D. S., Leon, M., Ellis, S. G., Goldberg, S., Hirshfeld, J. W., Cleman, M. W., Cabin, H. S., Walker, C., Stagg, J., Buchbinder, M., Teirstein, P. S., Topol, E. J., Savage, M., Ferez, J. A., Charles Curry, R., Whitworth, H., Eduardo Sousa, J., Tio, F., ... Palmaz, J. C. (1991). Clinical experience with the palmaz-schatz coronary stent: Initial results of a multicenter study. Circulation, 83(1), 148-161. https://doi.org/10.1161/01.CIR.83.1.148