Clinical experience with the Wiktor stent in native coronary arteries and coronary bypass grafts.

OBJECTIVES To evaluate the results of implantation of Wiktor tantalum wire coronary stents in stenosed or occluded coronary vessels or in saphenous vein bypass grafts. DESIGN A retrospective analysis of clinical and angiographic data from patients treated with tantalum wire stents implanted by one operator at two centres. PATIENTS 52 patients undergoing conventional balloon angioplasty had 67 lesions treated by stents after acute or threatened closure of the target vessel, or because the lesions concerned were considered to be at particularly high risk of becoming restenosed, or because the result of primary angioplasty was inadequate. RESULTS 65 of the 67 lesions were successfully stented although in two cases the first attempt failed and a second stent was then implanted successfully. There were no cases of stent occlusion and no myocardial infarctions in hospital or in the follow up period of 1-20 months. Eight patients had haemorrhagic complications that were minor in 4. One patient later had coronary bypass surgery after failure to stent a lesion. Angiographic follow up at a mean of 6 months after stenting showed restenosis associated with 4 of 47 stents studied. All patients with chest pain had had repeat angiography, and 84% of those without symptoms also agreed to reinvestigation after about 6 months. CONCLUSIONS The Wiktor tantalum wire stent is an effective means of treating acute complications during angioplasty and seems to offer hope of a significant reduction in the rate of late restenosis in both native coronary vessels and saphenous vein bypass grafts. A prospective comparison of balloon angioplasty and stenting is needed.