Stent placement compared with balloon angioplasty for small coronary arteries: In-hospital and 6-month clinical and angiographic results
Stenting has been demonstrated to be superior to balloon angioplasty in de novo focal lesions located in large native vessels. However, in small vessels, the benefit of stenting remains questionable. A total of 381 symptomatic patients with de novo focal lesion located on a small coronary segment ve...
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| Veröffentlicht in: | Circulation (New York, N.Y.) N.Y.), 2001-10, Vol.104 (14), p.1604-1608 |
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| creator | KONING, René ELTCHANINOFF, Hélène MORICE, Marie-Claude MAILLARD, Luc GUYON, Philippe PUEL, Jacques CRIBIER, Alain COMMEAU, Philippe KHALIFE, Khalife GILARD, Martine LIPIECKI, Janusz COSTE, Pierre BEDOSSA, Marc LEFEVRE, Thierry BRUNEL, Philippe |
| description | Stenting has been demonstrated to be superior to balloon angioplasty in de novo focal lesions located in large native vessels. However, in small vessels, the benefit of stenting remains questionable.
A total of 381 symptomatic patients with de novo focal lesion located on a small coronary segment vessel ( |
| doi_str_mv | 10.1161/hc3901.096695 |
| format | Article |
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A total of 381 symptomatic patients with de novo focal lesion located on a small coronary segment vessel (<3 mm) were randomly assigned to either stent implantation (192 patients; 197 lesions) or standard balloon angioplasty (189 patients; 198 lesions). The primary end point was the angiographic restenosis rate at 6 months, as determined by quantitative coronary angiography. On intention-to-treat analysis, angiographic success rate and major adverse cardiac events were comparable: 97.9% and 4.6% versus 93.9% and 5.8% in the stent group and the balloon group, respectively. After the procedure, a larger acute gain was achieved with stent placement (1.35+/-0.45 versus 0.94+/-0.47 mm, P=0.0001), resulting in a larger minimal lumen diameter (2.06+/-0.42 versus 1.70+/-0.46 mm, P=0.0001). At follow-up (obtained in 91% of patients), angiographic restenosis rate was 21% in the stent group versus 47% in the balloon group (P=0.0001), a risk reduction of 55%. Repeat target lesion revascularization was less frequent in the stent group (13% versus 25%, P=0.0006).
Elective stent placement in small coronary arteries with focal de novo lesions is safe and associated with a marked reduction in restenosis rate and subsequent target lesion revascularization rate at 6 months.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/hc3901.096695</identifier><identifier>PMID: 11581136</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Angioplasty, Balloon, Coronary - methods ; Biological and medical sciences ; Coronary Angiography ; Coronary Disease - diagnostic imaging ; Coronary Disease - mortality ; Coronary Disease - prevention & control ; Coronary Vessels ; Diseases of the cardiovascular system ; Female ; Follow-Up Studies ; Hospitalization ; Humans ; Male ; Medical sciences ; Middle Aged ; Myocardial Revascularization - methods ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Stents ; Survival Rate ; Treatment Outcome</subject><ispartof>Circulation (New York, N.Y.), 2001-10, Vol.104 (14), p.1604-1608</ispartof><rights>2002 INIST-CNRS</rights><rights>Copyright American Heart Association, Inc. Oct 2, 2001</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c345t-cc0c1496bfef1891ddd95befc2799001381c7a89ecdce6c7e752979d268781ef3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3685,27923,27924</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14075126$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11581136$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>KONING, René</creatorcontrib><creatorcontrib>ELTCHANINOFF, Hélène</creatorcontrib><creatorcontrib>MORICE, Marie-Claude</creatorcontrib><creatorcontrib>MAILLARD, Luc</creatorcontrib><creatorcontrib>GUYON, Philippe</creatorcontrib><creatorcontrib>PUEL, Jacques</creatorcontrib><creatorcontrib>CRIBIER, Alain</creatorcontrib><creatorcontrib>COMMEAU, Philippe</creatorcontrib><creatorcontrib>KHALIFE, Khalife</creatorcontrib><creatorcontrib>GILARD, Martine</creatorcontrib><creatorcontrib>LIPIECKI, Janusz</creatorcontrib><creatorcontrib>COSTE, Pierre</creatorcontrib><creatorcontrib>BEDOSSA, Marc</creatorcontrib><creatorcontrib>LEFEVRE, Thierry</creatorcontrib><creatorcontrib>BRUNEL, Philippe</creatorcontrib><creatorcontrib>BESMART (BeStent in Small Arteries) Trial Investigators</creatorcontrib><creatorcontrib>for the BESMART (BeStent in Small Arteries) Trial Investigators</creatorcontrib><title>Stent placement compared with balloon angioplasty for small coronary arteries: In-hospital and 6-month clinical and angiographic results</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>Stenting has been demonstrated to be superior to balloon angioplasty in de novo focal lesions located in large native vessels. However, in small vessels, the benefit of stenting remains questionable.
A total of 381 symptomatic patients with de novo focal lesion located on a small coronary segment vessel (<3 mm) were randomly assigned to either stent implantation (192 patients; 197 lesions) or standard balloon angioplasty (189 patients; 198 lesions). The primary end point was the angiographic restenosis rate at 6 months, as determined by quantitative coronary angiography. On intention-to-treat analysis, angiographic success rate and major adverse cardiac events were comparable: 97.9% and 4.6% versus 93.9% and 5.8% in the stent group and the balloon group, respectively. After the procedure, a larger acute gain was achieved with stent placement (1.35+/-0.45 versus 0.94+/-0.47 mm, P=0.0001), resulting in a larger minimal lumen diameter (2.06+/-0.42 versus 1.70+/-0.46 mm, P=0.0001). At follow-up (obtained in 91% of patients), angiographic restenosis rate was 21% in the stent group versus 47% in the balloon group (P=0.0001), a risk reduction of 55%. Repeat target lesion revascularization was less frequent in the stent group (13% versus 25%, P=0.0006).
Elective stent placement in small coronary arteries with focal de novo lesions is safe and associated with a marked reduction in restenosis rate and subsequent target lesion revascularization rate at 6 months.</description><subject>Angioplasty, Balloon, Coronary - methods</subject><subject>Biological and medical sciences</subject><subject>Coronary Angiography</subject><subject>Coronary Disease - diagnostic imaging</subject><subject>Coronary Disease - mortality</subject><subject>Coronary Disease - prevention & control</subject><subject>Coronary Vessels</subject><subject>Diseases of the cardiovascular system</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardial Revascularization - methods</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Stents</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpd0U1rHSEUBmApDc1t2mW3RQrtblKPjjp2F0I_AoEs0q4Hr3Mm1zCjU3Uo-Qf92TG9A4Gu_Hp8EV9C3gE7B1Dw-eCEYXDOjFJGviA7kLxtWinMS7JjjJlGC85Pyeuc7-tSCS1fkVMA2QEItSN_bwuGQpfJOpyfZi7Oi0040D--HOjeTlOMgdpw52NFuTzQMSaa53pQbYrBpgdqU8HkMX-hV6E5xLz4Yqd6aaCqmWOoQW7ywbtt81_aXbLLwTuaMK9TyW_IyWinjG-38Yz8-vb15-WP5vrm-9XlxXXjRCtL4xxz0Bq1H3GEzsAwDEbucXRcG8MYiA6ctp1BNzhUTqOW3GgzcNXpDnAUZ-TTMXdJ8feKufSzzw6nyQaMa-41cGi1ZBV--A_exzWF-raeA9dcd52sqDkil2LOCcd-SX6uX9ID65_66Y_99Md-qn-_ha77GYdnvRVSwccN2Fy_a0w2OJ-fXcu0BK7EIxX-mlo</recordid><startdate>20011002</startdate><enddate>20011002</enddate><creator>KONING, René</creator><creator>ELTCHANINOFF, Hélène</creator><creator>MORICE, Marie-Claude</creator><creator>MAILLARD, Luc</creator><creator>GUYON, Philippe</creator><creator>PUEL, Jacques</creator><creator>CRIBIER, Alain</creator><creator>COMMEAU, Philippe</creator><creator>KHALIFE, Khalife</creator><creator>GILARD, Martine</creator><creator>LIPIECKI, Janusz</creator><creator>COSTE, Pierre</creator><creator>BEDOSSA, Marc</creator><creator>LEFEVRE, Thierry</creator><creator>BRUNEL, Philippe</creator><general>Lippincott Williams & Wilkins</general><general>American Heart Association, Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>20011002</creationdate><title>Stent placement compared with balloon angioplasty for small coronary arteries: In-hospital and 6-month clinical and angiographic results</title><author>KONING, René ; ELTCHANINOFF, Hélène ; MORICE, Marie-Claude ; MAILLARD, Luc ; GUYON, Philippe ; PUEL, Jacques ; CRIBIER, Alain ; COMMEAU, Philippe ; KHALIFE, Khalife ; GILARD, Martine ; LIPIECKI, Janusz ; COSTE, Pierre ; BEDOSSA, Marc ; LEFEVRE, Thierry ; BRUNEL, Philippe</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c345t-cc0c1496bfef1891ddd95befc2799001381c7a89ecdce6c7e752979d268781ef3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Angioplasty, Balloon, Coronary - methods</topic><topic>Biological and medical sciences</topic><topic>Coronary Angiography</topic><topic>Coronary Disease - diagnostic imaging</topic><topic>Coronary Disease - mortality</topic><topic>Coronary Disease - prevention & control</topic><topic>Coronary Vessels</topic><topic>Diseases of the cardiovascular system</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocardial Revascularization - methods</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Stents</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>KONING, René</creatorcontrib><creatorcontrib>ELTCHANINOFF, Hélène</creatorcontrib><creatorcontrib>MORICE, Marie-Claude</creatorcontrib><creatorcontrib>MAILLARD, Luc</creatorcontrib><creatorcontrib>GUYON, Philippe</creatorcontrib><creatorcontrib>PUEL, Jacques</creatorcontrib><creatorcontrib>CRIBIER, Alain</creatorcontrib><creatorcontrib>COMMEAU, Philippe</creatorcontrib><creatorcontrib>KHALIFE, Khalife</creatorcontrib><creatorcontrib>GILARD, Martine</creatorcontrib><creatorcontrib>LIPIECKI, Janusz</creatorcontrib><creatorcontrib>COSTE, Pierre</creatorcontrib><creatorcontrib>BEDOSSA, Marc</creatorcontrib><creatorcontrib>LEFEVRE, Thierry</creatorcontrib><creatorcontrib>BRUNEL, Philippe</creatorcontrib><creatorcontrib>BESMART (BeStent in Small Arteries) Trial Investigators</creatorcontrib><creatorcontrib>for the BESMART (BeStent in Small Arteries) Trial Investigators</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>KONING, René</au><au>ELTCHANINOFF, Hélène</au><au>MORICE, Marie-Claude</au><au>MAILLARD, Luc</au><au>GUYON, Philippe</au><au>PUEL, Jacques</au><au>CRIBIER, Alain</au><au>COMMEAU, Philippe</au><au>KHALIFE, Khalife</au><au>GILARD, Martine</au><au>LIPIECKI, Janusz</au><au>COSTE, Pierre</au><au>BEDOSSA, Marc</au><au>LEFEVRE, Thierry</au><au>BRUNEL, Philippe</au><aucorp>BESMART (BeStent in Small Arteries) Trial Investigators</aucorp><aucorp>for the BESMART (BeStent in Small Arteries) Trial Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Stent placement compared with balloon angioplasty for small coronary arteries: In-hospital and 6-month clinical and angiographic results</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>2001-10-02</date><risdate>2001</risdate><volume>104</volume><issue>14</issue><spage>1604</spage><epage>1608</epage><pages>1604-1608</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>Stenting has been demonstrated to be superior to balloon angioplasty in de novo focal lesions located in large native vessels. However, in small vessels, the benefit of stenting remains questionable.
A total of 381 symptomatic patients with de novo focal lesion located on a small coronary segment vessel (<3 mm) were randomly assigned to either stent implantation (192 patients; 197 lesions) or standard balloon angioplasty (189 patients; 198 lesions). The primary end point was the angiographic restenosis rate at 6 months, as determined by quantitative coronary angiography. On intention-to-treat analysis, angiographic success rate and major adverse cardiac events were comparable: 97.9% and 4.6% versus 93.9% and 5.8% in the stent group and the balloon group, respectively. After the procedure, a larger acute gain was achieved with stent placement (1.35+/-0.45 versus 0.94+/-0.47 mm, P=0.0001), resulting in a larger minimal lumen diameter (2.06+/-0.42 versus 1.70+/-0.46 mm, P=0.0001). At follow-up (obtained in 91% of patients), angiographic restenosis rate was 21% in the stent group versus 47% in the balloon group (P=0.0001), a risk reduction of 55%. Repeat target lesion revascularization was less frequent in the stent group (13% versus 25%, P=0.0006).
Elective stent placement in small coronary arteries with focal de novo lesions is safe and associated with a marked reduction in restenosis rate and subsequent target lesion revascularization rate at 6 months.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>11581136</pmid><doi>10.1161/hc3901.096695</doi><tpages>5</tpages></addata></record> |
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| source | MEDLINE; American Heart Association Journals; Journals@Ovid Ovid Autoload; EZB-FREE-00999 freely available EZB journals |
| subjects | Angioplasty, Balloon, Coronary - methods Biological and medical sciences Coronary Angiography Coronary Disease - diagnostic imaging Coronary Disease - mortality Coronary Disease - prevention & control Coronary Vessels Diseases of the cardiovascular system Female Follow-Up Studies Hospitalization Humans Male Medical sciences Middle Aged Myocardial Revascularization - methods Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Stents Survival Rate Treatment Outcome |
| title | Stent placement compared with balloon angioplasty for small coronary arteries: In-hospital and 6-month clinical and angiographic results |
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