Side Branches and Coronary Stenting: Early Angiographic Changes

pp 453-456

Abstract

Background

The aim of this study was to assess the immediate effects of the deployment of Palmaz-Schatz and Gianturco-Roubin stents on the flow of side branchs arising from the stented arterial segments and their relationship with preexistent ostial disease, dissection or thrombus.

Methods

Seventieth-third stents were deployed in 66 patients overlaying a total of 123 side branchs that were classified into three groups: type A (luminal diameter > 1 mm without ostial stenosis), type B (luminal diameter >_ 1 mm with ostial stenosis) and type C (luminal diameter < 1 mm). Flow impairment was defined as a regression of one or more points in the TIMI scale (0, 1, 2 or 3). The last con-trol coronary angiogram was performed 50 ± 10minutes after the last insufflation.

Results

Flow impairment was present in 6.06% of type C,10.7% of type B and none of type A side branchs; the difference between types A and B was not statistically significant, but there was a trend towards occlusion in vessels with ostial stenosis. The presence of thrombus determined a significant impact in smaller side branchs (type C) (p < 0.0068). Dissection proved to be of no statistical importance on outcome.

Conclusions

Stenting with Palmaz-Schatz or Gianturco-Roubin devices does not modify flow in the majority of the side branchs arising from the stented segments; though major vessels with ostial disease and smaller vessels in the presence of thrombus merit greater attention.