Open AccessInitial clinical results with the wiktor stent: A new balloon‐expandable coronary stent
Author(s) -
Buchwald A.,
Unterberg C.,
Werner G.,
Kreuzer H.,
Wiegand V.,
Voth E.
Publication year - 1991
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960140504
Subject(s) - medicine , restenosis , angioplasty , right coronary artery , stent , cardiogenic shock , balloon , surgery , cardiology , coronary arteries , occlusion , artery , radiology , myocardial infarction , coronary angiography
The Wiktor stent, a new coronary balloon‐expandable tantalum stent, was implanted in 17 patients for otherwise nonmanageable occlusion after balloon angioplasty (n=11) and for recurrent restenosis (n=6). Stents of 3.0 to 4.0 mm were implanted (right coronary artery: n=10, left anterior descending artery: n=4, left circumflex artery: n=2, venous graft: n=1). All patients were fully anticoagulated initially with heparin followed by Coumadin for 3 months and were treated with acetylsalicylic acid indefinitely. Due to its good radiopacity, the device could be placed easily without complications. Early occlusion occurred in one patient after 8 h probably due to friable atheromatous material prolapsing between the meshes of the stent. Late occlusion occurred in another patient who was admitted in cardiogenic shock after prehospital reanimation and was stented after occlusive dissection following balloon angioplasty of an occluded right coronary artery. In this patient with severe hypoxic brain damage, reocclusion and reinfarction to which the patient finally succumbed occurred following cessation of anticoagulation. Histology demonstrated occlusive thrombosis without evidence of a neointimal covering of the stent. Another thrombotic occlusion due to inadvertent omission of anticoagulation occurred in another patient two weeks after stenting. Control angiography after 6 months in 12 patients revealed restenosis in two patients (50% and 80%). The patient with 80% restenosis of the right coronary artery and pathologic results during stress testing underwent surgical revascularization. The other patient with a 50% restenosis of the right coronary artery was managed medically as he was asymptomatic and without evidence of ischemia during stress testing. We conclude that, due to its good radiopacity, this new stent is technically easy to implant. Restenosis rate probably lies in the range of other devices. Anticoagulation before development of a neointimal covering is necessary to prevent reocclusion.