Between September 1993 and August 1994 we have implanted Palmaz-Schatz coronary stents in 44 patients. Twenty eight patients presented with stable angina and 16 with unstable angina. Stenting was carried out for denovo, focal lesions in large coronary arteries (n = 27), significant dissection during PTCA with acute threatened closure (n = 9), suboptimal results (n = 5), restenosis after PTCA (n = 2) and saphenous vein graft stenosis (n = 1). Successful delivery of the stent was achieved in 43 cases. Percent diameter stenosis was reduced from 77 +/- 11% to 10 +/- 8% and minimal luminal diameter increased from 1.08 +/- 0.28 mm to 2.92 +/- 0.39 mm. There was 1 death due to left main dissection secondary to guiding catheter trauma in a patient taken up for bail out stenting. Vascular/bleeding complications occurred in 3 patients (6.7%). There was no instance of acute or subacute stent thrombosis. Forty patients are symptom free. Eighteen patients underwent six month angiography. Restenosis (> 50% diameter reduction) was seen in 2 and a new lesion distal to stent occurred in 1 case. All have been successfully redilated. A high rate of successful delivery of the Palmaz-Schatz coronary stent can be achieved in a wide spectrum of patients with very few complications. Long term results are very gratifying and encouraging.

Angina Pectoris↗

PubMedDate not supplied

A follow up study of major intimal dissections treated with perfusion balloon catheter.

Major intimal dissections during coronary angioplasty are an important cause of early morbidity and mortality. In the recent past various non-surgical modalities to manage such dissections have been developed. The choice of therapy among these needs knowledge not only of immediate success but also of long term results. Data on long term follow up of patients managed with prolonged balloon inflations using a perfusion balloon catheter is limited. We herein report our experience of twenty seven consecutive patients managed by prolonged dilatations using Stack perfusion balloon catheter. All the patients had a long dissection with luminal compromise, 6 (22%) had in addition an acute complete occlusion, and in 4 (15%) there was a thrombus. Only 6 (22%) needed an emergency CABG, with the remaining having an event free hospital stay. At follow up after 6-26 months, 7/21 (33%) had severe symptoms and 5 of them underwent coronary arteriography with four having a repeat successful dilatation. The findings of this study suggest that the perfusion balloon catheter is a useful modality for management of major dissections with a restenosis rate similar to that of primary PTCA. Randomised controlled trials are required to assess its efficacy vis a vis the newer therapeutic options like stents, lasers and atherectomy.

Angioplasty, Balloon, Coronary↗

PubMedDate not supplied

Recurrent neurocardiogenic syncope in a patient with sick sinus syndrome.

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Adult↗