Interventional Conference

Bare Metal Stents

Basic Stent Design

Closed Cell design

Modular Cell design

High Pressure Inflation must balance vessel injury vs. stent approximation

POBA vs BMS

> 3 mm

< 3 mm

No difference in small vessels PTCA vs. Stent

Non benefit for BMS in small vessels

BMS in Acute MI

CABG vs. Stent

BMS in SVG

Saved• Description

Stenting vs. PTCA for angiographic restenosis in vein grafts.

• HypothesisTo compare stent implantation with balloon angioplasty for the treatment of obstructive disease of venous bypass grafts.

• Drugs/Procedures UsedPalmaz-Schatz coronary stent vs balloon angioplasty

• Concomitant Medications

• Patients assigned to stent placement received aspirin (325 mg qd) and dipyridamole (75 mg tid), beginning at least 24 hours before the procedure.

• During the procedure, patients received intravenous dextran 40 and heparin to maintain an activated clotting time of more than 300 seconds. Warfarin therapy was begun on the day of the procedure, and heparin therapy was continued until a therapeutic prothrombin time (international normalized ratio, 2.0 to 3.5) was achieved.

• Dipyridamole and warfarin were continued for one month, and aspirin indefinitely.

Use of Covered stent

Covered Jo stent in SVG

DES vs. BMS