Acute clinical and angiographic results with the new AVE Micro coronary stent in bailout management

To determine the feasibility and safety of deployment of this new stent, we deployed 28 AVE Micro stents in 23 native coronary artery lesions in 20 patients who developed acute or threatened closure after balloon angioplasty (BA). Ten stents were deployed in the left anterior descending artery, 10 in the circumflex, and 8 in the right coronary artery. Luminal dimensions were measured using a computer-based quantitative coronary angiographic analysis system (CAAS II). Stent deployment was successful in 27 of 28 attempts (96%). In 1 patient with a threatened closure of the left anterior descending artery associated with proximal vessel tortuosity, attempted stent deployment was unsuccessful. The clinical course of the other 19 patients in whom stent deployment was successful was free of coronary reintervention, bypass surgery, and death. A myocardial infarction was observed in 2 patients (10%), in 1 of whom the stent was implanted within 24 hours after the onset of acute myocardial infarction, and in the other acute vessel occlusion was present for 58 minutes before stent implantation. No subacute occlusion was observed. Event-free survival at 30 days after stent implantation was 85% (17 of 20 patients). Minimal luminal diameter was 0.85 ± 0.57 mm before and 1.19 ± 0.66 mm after BA, 2.61 ± 0.39 mm during balloon inflation, 3.26 ± 0.46 mm during and 2.74 ± 0.51 mm after stenting, 3.43 ± 0.52 mm during balloon inflation after stenting (Swiss Kiss), and 2.85 ± 0.48 mm after Swiss Kiss. Average percent diameter stenosis was reduced from 69% before through 56% after BA to 17% after stenting. During the initial stent implantation, stent recoil was 0.52 ± 0.30 mm (16 ± 9% of minimal luminal diameter during stent inflation). A Swiss Kiss was performed in 14 stents with an average pressure of 14 ± 4 atm, and residual stenosis was reduced from 2.55 mm (21% diameter stenosis) to 2.85 mm (15% diameter stenosis) in these lesions. Angiographic success (<30% residual diameter stenosis) was achieved in all stented lesions. The results of this early experience would indicate that the new AVE Micro stent may be deployed with a high procedural success rate and a minimal learning curve. Implantation of the stent for the bailout management of failed BA can be achieved with a low incidence of adverse cardiac events and a high angiographic success rate.