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Heart 1998;79:29-33; doi:10.1136/hrt.79.1.29
Copyright © 1998 BMJ Publishing Group Ltd & British Cardiovascular Society

Heart 1998;79:29-33 ( January )

Early and intermediate term clinical outcome after multiple coronary stenting

Anoop Chauhan, Erik Vu, Donald R Ricci, Christopher E Buller, Michael D Moscovich, Stephanie Monkman, Ian M Penn

Vancouver Hospital and Health Sciences Centre, University of British Columbia, Vancouver, British Columbia, Canada

Correspondence to: Dr Chauhan, Consultant Cardiologist, Blackpool Victoria Hospital, Whinney Hays Road, Blackpool, Lancashire FY3 8NR, UK.

Accepted for publication 28 August 1997

Objective---To examine the immediate and intermediate term clinical outcome of multiple coronary stenting.
Design---Consecutive patients were prospectively entered on a dedicated database. Follow up information was obtained from outpatient and telephone interviews with patients and family physicians.
Setting---A tertiary referral centre.
Patients---140 consecutive patients underwent multiple coronary stenting between April 1994 and November 1996. Most patients had unstable coronary syndromes.
Main outcome measures---Death, cerebrovascular accidents, myocardial infarction (MI), coronary artery bypass surgery (CABG), and repeat angioplasty (PTCA).
Results---The angiographic success rate was 100% and the clinical procedural success rate 93%. The mean (SD) follow up was 11.9 (7.2) months (range 2-32). The mean (SD) number of stents per patient was 2.4 (0.7). The mean (SD) number of lesions treated per patient was 1.4 (0.6). There were four in-hospital deaths (2.9%) and five patients (3.6%) had an MI before hospital discharge. All in-hospital deaths occurred in patients presenting with an acute MI and cardiogenic shock. Three patients (2.2%) had a late MI. One patient with stent thrombosis underwent emergency CABG. Three patients (2.2%) underwent late CABG. Eight patients (5.7%) had a repeat PTCA. Eighty three patients (61.5%) were asymptomatic at follow up and 121 (86.4%) were free from major clinical events.
Conclusion---In an era of increased operator experience, high pressure stent deployment, and reduced anticoagulation with antiplatelet treatment alone, multiple coronary stenting may be performed with a high procedural success rate and good intermediate term outcome.

Keywords: angioplasty;  stents;  clinical outcome;  interventional cardiology

© 1998 by Heart
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