الفهرس 
coronary stenting overviewOnly 14 pages are availabe for public view
 |  | from | 196 |  |  |
| | | from | 196 | | |
Abstract
The establishment of stent implantation in interventional
cardiology was a decisive step in extending the therapeutic
options in the treatment of coronary artery disease (CAD), Even
though the treatment of CAD has been considerably improved
by stent implantation, restenosis still remains an unsolved
problem.
In-stent restenosis results from an excessive fibro-proliferative
and inflammatory response to arterial wall insults. This
inflammatory response and development of restenosis are
increased by a contact-allergic reaction to metal compounds
released from stainless-steel stents. Carbon ions – by coating
the stents- were suggested to decrease the hypersensitivity
mediated in-stent restenosis.
This study is an attempt to assess the role of the inert stents
in decreasing the incidence of restenosis after percutaneous
coronary intervention (PCI) and evaluate the clinical outcome
of these stents.
Between May 2003 and December 2005; 57 pts with
angiographically documented CAD, admitted to the Critical Care
Department in Benha university hospital were enrolled in the
study (49 males, 8 females, mean age 50 years) who
underwent stent implantation in 57 de novo lesions.
We studied 57 high risk lesions in the 57 pts divided into two
groups; group I for which the traditional bare metal Stainlesssteel
stents were deployed (30 lesions in 30 pts; 26 M, 4 F with
a mean age of 50 yrs)., group II for which Inert stents were
______________________________________________________________Summary ___________
144
deployed (27 lesions in 27 pts; 23 M, 4 F with a mean age of 51
yrs)
Angioplasty was performed via right femoral approach using
routine procedures and 6, 7, & 8 F guiding catheters. Preintervention
medications included intra-venous Heparin and oral
Clopidogrel 300 mg loading dose.
Procedural success: was defined as ≤ 30 % residual stenosis
post procedure. Clinical success: was defined as procedural
success without the occurrence of MACE (death, MI, or TVR).
Clinical follow-up for the occurrence of MACE was performed
one and six months after the procedure. Angiographic follow-up
was after six months or after the occurrence of any of the
clinical endpoints.
Procedural and clinical successes were documented in 100 %
of our pts. During hospital stay, there was no MACE in all
groups. None of our pts developed MACE during the 30-days
follow-up period.
At 6-months follow-up, there was no statistically significant
difference between the 2 groups regarding the occurrence of
MACE.
Restenosis rate showed also no statistically significant
difference between the 2 groups (16.7%, and 18.5% in
stainless-steel stents and Inert stents, respectively, P = > 0.05)
______________________________________________________________Summary ___________
145
The implantation of Inert stent is safe and feasible, with a high
acute procedural success. These stents proved also favorable
short term results regarding the thrombotic complication.
Inert stent did not add to the bare metal uncoated stainlesssteel
stents regarding 6-months in-stent restenosis.
Multicenter, prospective, randomized, controlled, and doubleblinded
studies with a large number of pts are warranted to
evaluate the efficacy of these stents in that respect