Percutaneously implantable endo-coronary prosthesis

Summary

A promising new approach to reduce post-dilatation restenosis is the use of self-expanding endocoronary scaffolding or wall stent device. So far we have implanted the stent in 25 coronary patients; in 24 of these patients this was done post-dilatation to prevent coronary restenosis, and in 1 case the stent was placed at a stenosis in a venous coronary artery bypass graft. There were 15 event-free implantations with excellent angiographic follow-up ranging from 3 to 12 months in 14 cases. Acute or early occlusion (before the tenth day post-implant) occurred in 10 cases, probably related to technical complications of the implantation in 2 cases, to inadequate heparinization in 3 cases, to previous transmural myocardial infarction distal to the stent in 3 cases, and to inadequate congruence between the stent and the native coronary artery in 2 cases. Thus, the risk of a thrombus is more acute in the first two weeks post-implant. However, we have noted that the rate of early occlusion is decreasing with our familiarization with the device, optimisation of the drug therapy and of the patient selection. Beyond this critical period, our preliminary results are encouraging and suggest that the intra-coronary stent might be a promising adjunct to transluminal coronary angioplasty.