Journal article
A Randomized Comparison of Coronary-Stent Placement and Balloon Angioplasty in the Treatment of Coronary Artery Disease
The New England journal of medicine, v 331(8), pp 496-501
25 Aug 1994
PMID: 8041414
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background Coronary-stent placement is a new technique in which a balloon-expandable, stainless-steel, slotted tube is implanted at the site of a coronary stenosis. The purpose of this study was to compare the effects of stent placement and standard balloon angioplasty on angiographically detected restenosis and clinical outcomes. Methods We randomly assigned 410 patients with symptomatic coronary disease to elective placement of a Palmaz-Schatz stent or to standard balloon angioplasty. Coronary angiography was performed at base line, immediately after the procedure, and six months later. Results The patients who underwent stenting had a higher rate of procedural success than those who underwent standard balloon angioplasty (96.1 percent vs. 89.6 percent, P = 0.011), a larger immediate increase in the diameter of the lumen (1.72 ±0.46 vs. 1.23 ±0.48 mm, P<0.001), and a larger luminal diameter immediately after the procedure (2.49 ±0.43 vs. 1.99 ±0.47 mm, P<0.001). At six months, the patients with stented lesions continued to have a larger luminal diameter (1.74 ±0.60 vs. 1.56 ±0.65 mm, P = 0.007) and a lower rate of restenosis (31.6 percent vs. 42.1 percent, P = 0.046) than those treated with balloon angioplasty. There were no coronary events (death; myocardial infarction; coronary-artery bypass surgery; vessel closure, including stent thrombosis; or repeated angioplasty) in 80.5 percent of the patients in the stent group and 76.2 percent of those in the angioplasty group (P = 0.16). Revascularization of the original target lesion because of recurrent myocardial ischemia was performed less frequently in the stent group than in the angioplasty group (10.2 percent vs. 15.4 percent, P = 0.06). Conclusions In selected patients, placement of an intracoronary stent, as compared with balloon angioplasty, results in an improved rate of procedural success, a lower rate of angiographically detected restenosis, a similar rate of clinical events after six months, and a less frequent need for revascularization of the original coronary lesion.
Metrics
Details
- Title
- A Randomized Comparison of Coronary-Stent Placement and Balloon Angioplasty in the Treatment of Coronary Artery Disease
- Creators
- David L Fischman - Jefferson College of Health SciencesMartin B LeonDonald S Baim - Beth Israel Deaconess HospitalRichard A Schatz - Scripps ClinicMichael P Savage - Jefferson College of Health SciencesIan Penn - Victoria General HospitalKatherine Detre - University of PittsburghLisa Veltri - University of PittsburghDonald Ricci - Vancouver General HospitalMasakiyo Nobuyoshi - Kokura Memorial HospitalMichael Cleman - Yale UniversityRichard Heuser - Arizona Heart InstituteDavid Almond - Toronto General HospitalPaul S Teirstein - Scripps ClinicR David Fish - St. Luke's HospitalAntonio Colombo - EMO GVM Centro Cuore ColumbusJeffrey Brinker - Johns Hopkins HospitalJeffrey Moses - Lenox Hill HospitalAlex Shaknovich - Lenox Hill HospitalJohn Hirshfeld - Hospital of the University of PennsylvaniaStephen Bailey - The University of Texas at San AntonioStephen Ellis - Cleveland ClinicRandal Rake - Jefferson CollegeSheldon Goldberg - Jefferson College of Health Sciences
- Publication Details
- The New England journal of medicine, v 331(8), pp 496-501
- Publisher
- Massachusetts Medical Society
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Cardiothoracic Surgery; Medicine (Graduate)
- Web of Science ID
- WOS:A1994PD07200002
- Scopus ID
- 2-s2.0-0027934377
- Other Identifier
- 991021960655504721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems