Coronary Artery DiseaseClinical Outcome at Six Months of Coronary Stenting Followed by Ticlopidine Monotherapy
Section snippets
Patients:
The study group consisted of 263 consecutive, unselected patients undergoing elective coronary stent deployment not guided by intravascular ultrasound and followed by ticlopidine monotherapy at our institution from January 1995 to February 1996. Patients with contraindications to the study medication or patients receiving oral anticoagulation for other medical conditions (e.g., valvular disorder, atrial fibrillation, ventricular thrombi, and so forth) were excluded. There were no restrictions
Results
The anatomic distribution of the treated lesions are summarized in Table II. Balloon sizes were 3.3 ± 0.4 mm and inflation pressures 15.0 ± 0.4 bar. Fig. 2 shows an example of a stenting procedure. The results of periprocedural quantitative angiography are listed in Table III.
We observed 7 instances (2.7 of 100 patients) of stent dislocation during the deployment procedure. Two stents embolized into the peripheral circulation without clinical sequelae. In 5 patients (1.9 of 100 patients),
Discussion
The results of the present study demonstrate that coronary stent deployment followed by ticlopidine monotherapy is safe and effective in an unselected population. The overall clinical outcome at 6 months is good and comparable to that of patients treated with combined antiplatelet therapy. Coronary artery stents are increasingly used in a variety of clinical situations. The high complication rates associated with the aggressive oral anticoagulation regimens of the early stenting era1, 2, 6, 9
Acknowledgements
Acknowledgment:
We are indebted to Andreas M. Zeiher, MD, for his critical review of the manuscript.
References (30)
- et al.
Stratification of the risk of thrombosis after intracoronary stenting for threatened or acute closure complicating coronary balloon angioplastya Cook registry study
Am Heart J
(1995) - et al.
Angiographic and clinical outcome of intracoronary stentingimmediate and long-term results from a large single-center experience
J Am Coll Cardiol
(1992) - et al.
Complications and follow-up after intracoronary stenting: critical analysis of a 6-year single-center experience
Am Heart J
(1994) - et al.
Comparison of aspirin alone versus aspirin plus ticlopidine after coronary artery stenting
Am J Cardiol
(1996) - et al.
Antiplatelet rather than anticoagulant therapy with coronary stenting
Lancet
(1997) - et al.
Subacute stent thrombosis in the era of intravascular ultrasound-guided coronary stenting without anticoagulationfrequency, predictors and clinical outcome
J Am Coll Cardiol
(1997) - et al.
Clinical experience with the Palmaz-Schatz coronary stent
J Am Coll Cardiol
(1991) - et al.
Anticoagulation after intracoronary stent insertion
Br Heart J
(1994) - et al.
Predictors of thrombotic complications after placement of the flexible coil stent
Am J Cardiol
(1994) - et al.
Relation of thrombotic occlusion of coronary stents to the indication for stenting, stent size, and anticoagulation
Am J Cardiol
(1995)
Complications of coronary stenting
Coron Artery Dis
Endovascular stentspreliminary clinical results and future developments
Clin Cardiol
Intracoronary stenting without anticoagulation accomplished with intravascular ultrasound guidance
Circulation
Intracoronary stenting without coumadinone month results of a french multicenter study
Cathet Cardiovasc Diagn
Coronary stenting without anticoagulation
Cathet Cardiovasc Diagn
Cited by (11)
Coronary artery stents: Review and patient-management recommendations
2000, Journal of the American Dental AssociationCitation Excerpt :As part of this protocol, warfarin was initiated on hospital discharge and was continued for up to three months postoperative; aspirin (with or without dipyridamole) is continued indefinitely.2 Several studies, however, now indicate that such an intense anticoagulation regimen is not routinely necessary, and both restenosis and postoperative complications are reduced with a regimen of aspirin and ticlopidine,4,14,21–23,30,31 or ticlopidine alone.32 Most recently, developments include in-hospital use of newer platelet antagonists such as abciximab, the use of β-particle–emitting stents, or the use of brachytherapy with either β- or γ- radiation to reduce the rate of stent restenosis.18
Subacute stent thrombosis in a nonselected population using antiplatelet therapy: Frequency and predictors
2000, Revista Espanola de CardiologiaAntibiotic prophylaxis in dental patients with body prostheses
2002, Medicina OralAmbulatory use of ticlopidine and clopidogrel in association with percutaneous coronary revascularization procedures in a national managed care organization
2002, Journal of Interventional Cardiology