Clinical and Angiographic Outcome Following Implantation of the New Less Shortening Wallstent in Aortocoronary Vein Grafts: Introduction of a Second Generation Stent in the Clinical Arena

One of the factors felt to have contributed to the high rate of stent occlusion in the European registry of the coronary Wallstent in the 1980s was the frequent deployment of more than one stent to cover the target lesion. This resulted from a high degree of shortening of the Wallstent upon expansion. To overcome this limitation the design of the Wallstent was modified to reduce the degree of shortening. We report the results of a study of the first patients to undergo implantation of the new Less Shortening Wallstent. Thirty‐five Wallstents were electively deployed in aortocoronary vein grafts in 29 patients. Stent deployment was successful in 35 of 36 attempts in 30 lesions. In five of the 30 lesions, a second scent was required to cover the proximal portion of the lesion. Angiographic success (< 50% residual diameter stenosis as determined by off‐line quantitative coronary angiography) was achieved in all 29 patients. During the in‐hospital phase, no tnajor adverse cardiac event occurred (reintervention, re‐CABG, myocardial infarction, or death) and five patients had hemorrhagic complications. Following hospital discharge, one patient had a subacute stent occlusion associated with symptoms and elevated cardiac enzymes at 11 days, another patient had symptoms and elevated cardiac enzymes (CK 300 U/I) at 22 days with a patent stem, five patients required balloon angioplasty within the 6 month follow‐up period (four for restenosis and one for stent occlusion), one patient underwent re‐CABG for a native artery stenosis distal to the anastomosis of the patent stented vein graft. The results of this introductory study suggest that the new Less Shortening Wallstent may be associated with a reduction in the requirement for multiple stern deployment and a lower rate of thrombotic occlusion in comparison to its pioneering prototype. On the basis of these results, a number of larger multicenter clinical trials have been initiated to, further evaluate the new coronary Wallstent. (J Interven Cardiol 1994:7:557–564)