Coronary artery stents

In summary, the committee concludes that elective stenting in selected patient subsets enhances the result of percutaneous coronary interventional procedures. In these subsets, the Palmaz-Schatz stent, used electively, reduces the risk for I restenosis and need for repeat interventional procedures compared with PTCA alone. When used for acute or threatened closure, stenting reduces, but does not eliminate, the need for emergency CABG. The committee also strongly recommends caution in generalizing these findings to other situations for which coronary stenting is considered. We are concerned about the rapid proliferation and application of this technique to very large groups of patients without adequate supporting data, particularly those patients with stenoses other than nonrestenotic lesions in large vessels. In addition, we are concerned about the lack of intermediate- to long-term follow-up data, especially with regard to non-Q wave MI and mortality. We strongly urge interventional cardiologists to practice caution when considering application of coronary stents until more controlled trial data are available. Particular caution should be extended in use of stents in scenarios where benefit has not been proved, such as treatment of ostial or left main coronary artery lesions, small vessels, chronic total occlusions, acute MI, restenotic lesions, long lesions or diffuse disease.