Long-term clinical and angiographic follow-up after placement of Palmaz-Schatz coronary stent: a single center experience.

The purpose of this study is to evaluate long-term clinical and angiographic follow-up results after placement of the Palmaz-Schatz stent and angiographic follow-up results of repeat interventions for stent restenosis. From June 1990 to September 1993, the Palmaz-Schatz stent was placed in 411 patients, 427 lesions. Follow-up angiography was performed in 307 lesions at 3-6 months and in 189 lesions at 1 year. Palmaz-Schatz stent implantation resulted in 97.2% procedure success and 94.6% clinical success. Stent thrombosis was observed in 2.2%. Angiographic restenosis rate was 16.3% at 3-6 months study. At 1 year study, "new" restenosis occurred only in 2.3%. Minimal lumen diameter did not change between 6 months and 1 year (2.32 +/- 0.51 mm vs 2.30 +/- 0.54 mm). With the mean follow-up interval of 22 +/- 9 months, cardiac event-free survival was achieved in 74.3%. Among 50 lesions with restenosis, stent restenosis occurred diffusely in 15 lesions (30%), focally inside the stent in 22 lesions (44%) and focally at the stent border in 13 lesions (26%). Repeat interventions were performed in 35 lesions. Restenosis at 3 months after repeat intervention was demonstrated in 9 (32.1%) out of 28 lesions restudied. Restenosis rate after repeat intervention for diffuse stent restenosis was significantly higher than that for focal in-stent restenosis (75% vs 7.7%). Palmaz-Schatz stent implantation was associated with a high initial success rate and a low late restenosis rate. Luminal renarrowing did not occur beyond 6 months up to 1 year.