Background Coronary-artery stents are known to reduce ratesof restenosis after coronary angioplasty, but it is uncertainhow long this benefit is maintained.
Methods We evaluated clinical and angiographic follow-up informationfor up to three years after the implantation of Palmaz–Schatzmetallic coronary-artery stents in 143 patients with 147 lesionsof native coronary arteries.
Results The rate of survival free of myocardial infarction,bypass surgery, and repeated coronary angioplasty for stentedlesions was 74.6 percent at three years. After 14 months, revascularizationof the stented lesion was necessary in only three patients (2.1percent). In contrast, coronary angioplasty for a new lesionwas required in 11 patients (7.7 percent). Follow-up coronaryangiography of 137 lesions at six months, 114 lesions at oneyear, and 72 lesions at three years revealed a decrease in minimalluminal diameter from 2.54±0.44 mm immediately afterstent implantation to 1.87±0.56 mm at six months, butno further decrease in diameter at one year (in patients withpaired angiograms, 1.95±0.49 mm at both six months andone year). Significant late improvement in luminal diameterwas observed at three years (in patients with paired angiograms,1.94±0.48 mm at six months and 2.09±0.48 mm atthree years; P<0.001).
Conclusions Clinical and angiographic outcomes up to three yearsafter coronary-artery stenting were favorable, with a low rateof revascularization of the stented lesions. Late improvementin luminal diameter appears to occur between six months andthree years.
Since the initial report by Sigwart et al.1 of the placementof metallic stents in coronary arteries, coronary-artery stentinghas been shown to optimize the geometry of the coronary lumenafter balloon angioplasty,2,3 reducing procedural complications4,5and late restenosis.6-8 Two recent randomized trials (the StentRestenosis Study [STRESS]9 and the Benestent study10) comparingstenting with standard balloon angioplasty in primary focallesions clearly demonstrated the efficacy of the Palmaz–Schatzstent in reducing the rate of angiographically detected restenosis.In the Benestent trial, there was both angiographic and clinicalbenefit, as reflected by a reduction in major clinical end points,especially repeated coronary angioplasty. Colombo et al.11,12revolutionized the technique of stent implantation by demonstratingthat high-pressure balloon dilatation at the end of the procedure,with confirmation by intravascular ultrasonography of adequatestent expansion and full coverage of the lesion, was associatedwith a low rate of stent thrombosis without anticoagulant therapy.
Despite these promising observations, one of the uncertaintiesof coronary stenting concerns the long-term outcome after thepermanent placement of metallic prosthetic devices.13 To addressthis issue, we evaluated clinical data as well as serial quantitativeangiographic information six months, one year, and three yearsafter the placement of single Palmaz–Schatz stents innative coronary arteries.
Methods
Study Patients
From June 1990 through January 1992, 160 consecutive patientsunderwent the implantation of a Palmaz–Schatz stent. Onepatient had multiple stents, 16 patients had saphenous-veingrafts as their target lesions, and 143 patients underwent theimplantation of single Palmaz–Schatz stents in 147 nativecoronary lesions. All the patients gave informed consent forthe procedure and the follow-up treatment, which was approvedby the institutional review board.
Stent Placement and Anticoagulant Therapy
All stents were implanted with a commercially available stent-deliverysystem (Johnson & Johnson) by standard techniques.6 Themean (±SD) size of the expanded balloon was 3.48±0.39mm for vessels 3.12±0.61 mm in diameter. The final inflationpressure was 9.7±2.1 atmospheres. Procedural successwas defined as the successful deployment of the stent, resultingin stenosis of less than 50 percent as measured by quantitativecoronary angiography. Clinical success was defined as proceduralsuccess with no major in-hospital complications, such as death,myocardial infarction, or the need for bypass surgery. The conventionalregimen of anticoagulant therapy included aspirin, dipyridamole,dextran, heparin, and warfarin and has been described in detailelsewhere.8
Clinical Follow-Up
Clinical follow-up data were obtained by either a review ofthe hospital records or telephone contact with the patientsor their referring physicians. The major clinical events studiedwere death, myocardial infarction, bypass surgery, revascularizationof the target lesion, and coronary angioplasty of nonstentedlesions. Death was defined to include death from any cause.Myocardial infarction was defined as an increase in serum creatinekinase activity to more than twice the normal value, in associationwith new, pathologic Q waves. In the event of "bailout" stentingwhen there was abrupt closure of the lumen, an elevation increatine kinase was not considered to constitute a stent-relatedmyocardial infarction if the procedure resulted in the restorationof grade 3 flow according to the criteria of the Thrombolysisin Myocardial Infarction trial.14 Bypass surgery was definedas any surgical revascularization, even if the stented segmentwas patent. Revascularization of the target lesion was definedas either bypass surgery or balloon angioplasty involving thestented segments. Clinical follow-up events were studied accordingto the intention-to-treat principle. In-hospital events wereincluded in the analysis of follow-up events. Repeated balloonangioplasty for subacute stent thrombosis was considered toconstitute revascularization of the target lesion.
Angiographic Follow-Up
According to the study protocol, follow-up angiography was tobe performed six months, one year, and three years after theprocedure. Although many patients in the study cohort actuallyunderwent multiple angiographic procedures within the firstsix months after follow-up,8 angiograms obtained less than threemonths after the procedure were regarded as having been obtainedat six months if they revealed restenosis requiring revascularizationof the target lesion; similarly, angiography performed betweenfour and nine months after stent implantation was included amongthe studies done at six months. Although repeated coronary angioplastyperformed to treat subacute stent thrombosis was consideredrevascularization of the target lesion in the analysis of clinicalfollow-up data, subacute stent thrombosis was not consideredto constitute angiographic restenosis, because the underlyingmechanisms seemed to be different. Therefore, lesions that underwentsuccessful revascularization for subacute stent thrombosis wereconsidered to be eligible for subsequent angiographic follow-up.The 1-year follow-up studies were defined as those performedbetween 10 and 18 months, and the 3-year follow-up studies asthose performed after 27 months.
Quantitative angiographic analysis was performed with the commerciallyavailable Cardiovascular Angiography Analysis System II.15 Theview showing the most stenosis after stent implantation butwith no substantial overlapping of the study vessel with otherbranches and no foreshortening was selected from among multipleprojections. Quantitative analysis of the control and follow-upangiograms was performed in nearly identical views, with anintracoronary injection of 2.5 to 5 mg of isosorbide dinitrateadministered before each study. Catheters that did not containcontrast medium were used for calibration whenever possible.Proximal and distal reference points were defined by the operatorbefore the intervention, and the length of the lesion, minimalluminal diameter, reference diameter (as derived by interpolation),and percentage of stenosis between those points were calculatedby the computer. In the post-intervention and follow-up studies,the same reference points were selected by the operator, andthe minimal luminal diameter between the two points was determinedby the computer even when the most severe narrowing was outsidethe stent. Restenosis was defined as stenosis of 50 percentor more observed at follow-up.
To assess intraobserver variability and the reproducibilityof the quantitative angiographic analysis, 30 randomly selectedpairs of follow-up angiograms obtained at six months and threeyears were analyzed, with the observer kept unaware of whenthe angiogram had been obtained. The variations in the readingsof minimal luminal diameter were 0.002±0.11 mm for thesix-month studies and 0.003±0.11 mm for the three-yearstudies; the correlation coefficients for repeated measurementswere 0.98 at six months and 0.98 at three years (P<0.001for both).
Statistical Analysis
Values are expressed as means ±SD. Categorical variableswere compared by the chi-square test. Paired numerical dataobtained by serial angiography were compared by the paired t-test,and other continuous variables by the unpaired t-test. Linearregression analysis was used to assess the reproducibility ofquantitative angiography and predictors of long-term increasein luminal diameter. Rates of event-free survival were studiedwith Kaplan–Meier analysis.16 All tests of significancewere two-tailed, and P values of less than 0.05 were consideredto indicate statistical significance.
Results
In-Hospital Outcome
The base-line characteristics of the patients and the coronarylesions are shown in Table 1. Among the 143 patients (with 147coronary lesions), 139 patients (97.2 percent) and 143 lesions(97.3 percent) underwent successful stent implantation. Therewas clinical success in 133 patients (93.0 percent). The majorcomplications included death in three patients (2.1 percent),myocardial infarctions with Q waves in seven (4.9 percent),and non–Q-wave myocardial infarctions in three patients(2.1 percent). Emergency bypass surgery was not needed to treatany patient. Bleeding complications requiring either surgeryor blood transfusion were observed in four patients (2.8 percent).Six patients (4.2 percent) had subacute thrombosis of the stentbetween three and seven days after stent implantation; fiveof these patients underwent successful revascularization andwere discharged with patent stents. Therefore, including those5 patients, 136 patients (with 140 lesions) who survived todischarge with patent stents were eligible for the six-monthangiographic follow-up.
Table 1. Base-Line Characteristics of the Patients and Lesions.
Clinical Follow-Up
The cumulative survival rates were 93.7 percent one year afterimplantation of the stent, 92.2 percent after two years, and90.8 percent after three years (Figure 1). Besides the threepatients who died in the hospital, six additional patients diedduring the first 14 months (Table 2). One patient who had previouslyhad bypass surgery and in whom bailout stenting for the circumflexcoronary artery was unsuccessful died of cardiogenic shock dueto occlusion of the venous graft to the left anterior descendingcoronary artery. One patient died of congestive heart failurethat was presumably related to restenosis of the stented lesion.Two patients died suddenly, although angiography at six monthsconfirmed that they did not have restenosis. Two other patientsdied from noncardiac causes (meningitis and an accident). Fouradditional patients died after 14 months from definite noncardiaccauses (renal failure in one, subarachnoid hemorrhage in one,and cancer in two).
Figure 1. Kaplan–Meier Curves for Event-free Survival in the Study Patients.
The number of patients at risk for each event or combination of events is shown below the graph for each time point. The percentages in the figure are the event-free survival rates at three years (indicated by the vertical line).
Table 2. Frequency of Events Studied during Clinical Follow-up.
The rates of survival free of myocardial infarction, bypasssurgery, and revascularization of the target lesion were 80.4percent at one year, 76.8 percent at two years, and 74.6 percentat three years (Figure 1). Revascularization of the target lesionwas performed in 24 patients (16.8 percent). However, when repeatedcoronary angioplasty related to subacute stent thrombosis wasnot counted, the rate of revascularization of the target lesionat three years was only 12.6 percent. Revascularization of thetarget lesion was performed in only three patients (2.1 percent)after 14 months. Two revascularization procedures were relatedto asymptomatic restenosis at 15 and 37 months, after the 1-yearand 3-year angiography, respectively. The other case of revascularizationof the target lesion was related to symptomatic restenosis at27 months. Thus, there was only one case (0.7 percent) in whichrevascularization of a target lesion was performed because ofclinical symptoms after 14 months. In contrast, coronary angioplastywas required for a new lesion in 11 patients (7.7 percent) after14 months.
Outcome of Angiographic Follow-Up
Among 136 patients and 140 lesions eligible for the six-monthangiographic follow-up, 133 patients and 137 lesions (98 percent)underwent angiography at six months, a mean of 184±34days after stent implantation. Subsequently, 5 patients diedand 13 patients had revascularization of their target lesionswithin 12 months, leaving 122 lesions in 118 patients eligiblefor subsequent angiographic follow-up. One-year angiographywas performed in 114 lesions (110 patients, or 93 percent) 375±32days after implantation, and three-year angiography was performedin 72 lesions (68 patients, or 59 percent) after a mean periodof 1071±103 days.
The specific reasons for the failure of patients to undergoangiography after three years were refusal by either the patientor the referring physician (in 36 asymptomatic patients), death(in 3), repeated angioplasty after the one-year angiography(in 3), concomitant medical problems (in 2), and loss to follow-up(in 3). In three other patients, angiography demonstrating theabsence of restenosis was actually performed at three years,but the cine films were not available for study. In an effortto compensate for the incomplete three-year data, the characteristicsof patients and lesions were compared between the group thathad angiography at three years and the group that did not (Table 3).Both base-line characteristics and quantitative angiographicvariables at six months of follow-up were similar between thesetwo groups.
Table 3. Comparison of Patients and Lesions Studied Angiographically at Three Years with Those Not So Studied.
The results of immediate and long-term quantitative angiographyare shown in Table 4. Minimal luminal diameter was increasedfrom 1.05±0.37 mm to 2.54±0.44 mm immediatelyafter stent implantation, but by six months it had decreasedto 1.87±0.56 mm. Angiographic restenosis was documentedin 25 lesions (18.2 percent).
Table 4. Immediate and Long-Term Results of Quantitative Angiography.
In 114 lesions for which there were paired angiograms obtainedat six months and one year, there was no further decrease inminimal luminal diameter during the period from six months toone year (diameter at both study times, 1.95±0.49 mm;P = 0.73) (Figure 2A). In 72 lesions for which sequential studieswere completed for up to three years, there was significantimprovement in minimal luminal diameter at three years (diameterat six months, 1.94±0.48 mm; at three years, 2.09±0.48mm; P<0.001) (Figure 3). Among seven patients who had angiographicrestenosis at six months, only one still had more than 50 percentstenosis at three years. A case of marked luminal improvementthree years after stent implantation is shown in Figure 4. Onlytwo lesions (2.8 percent) were observed to have substantialluminal renarrowing after six months (Figure 2B).
Figure 2. Minimal Luminal Diameters of the Study Vessels Six Months after Stent Implantation, as Compared with the Diameters Measured at One Year (Panel A) and Three Years (Panel B).
At the one-year follow-up, the values for all the lesions, including those that later underwent revascularization, were clustered along the line of identity, indicating little change from the six-month values. The mean (±SD) change in minimal luminal diameter during this period was a decrease of 0.002±0.24 mm. Mean minimal luminal diameter at three years was increased by 0.15±0.36 mm from the diameter measured at six months. Only two lesions decreased substantially in minimal luminal diameter during this interval.
Figure 3. Serial Changes in the Mean (±SD) Minimal Luminal Diameter of 72 Lesions for Which Sequential Studies over a Three -Year Period. Were Completed (•), as Compared with a Reference Diameter ().
There was significant improvement in minimal luminal diameter during the period from one year to three years after implantation of the stent. P<0.001 for the comparison between the points linked by brackets.
Figure 4. Angiograms Showing Marked Luminal Improvement in a Patient after Three Years.
Coronary-stent implantation was performed electively in this patient for a primary lesion of the left anterior descending coronary artery. The minimal luminal diameter of the vessel improved from 0.68 mm before the intervention (upper left) to 2.63 mm immediately after the implantation of the stent (upper right). At six months (lower left), the diameter had decreased to 1.49 mm, but at three years (lower right), it had increased to 2.31 mm.
Late increases in luminal diameter between six months and threeyears were significantly correlated with early decreases inluminal diameter during the time from immediately after theprocedure to the six-month follow-up (r = 0.34, P = 0.004).The index for later increase in diameter, defined as the increasein luminal diameter during the period from six months to threeyears after stent implantation divided by the decrease in diameterfrom immediately after the procedure to the six-month follow-up,was 0.27±1.27. Later increases in luminal diameter atthree years were also negatively correlated with minimal luminaldiameter at six months (r = 0.4, P<0.001).
The formation of an aneurysm was noted on angiography at sixmonths in one patient; at the three-year follow-up, the aneurysmhad nearly the same appearance. No other potentially deleteriousvascular effects were observed during the three years of follow-up.
Discussion
This study was designed to evaluate the long-term safety andefficacy of the placement of metallic stents in coronary arteries.Quantitative angiographic outcome at three years was analyzed,as well as clinical outcome, to establish late patency of thestent and confirm the absence of deleterious angiographic findingsrelated to stent implantation.
In this study, the patients' rate of survival free of myocardialinfarction, bypass surgery, and revascularization of the targetlesion was 80.4 percent at one year, a figure similar to thevalues of 80.5 percent in the stent group studied in the STRESS9trial at eight months and 79.9 percent in the correspondinggroup in the Benestent10 trial at seven months; apparently,this was a higher rate than has been attained with other interventionaldevices. Detre et al.17 reported an event-free survival rateof 66 percent one year after standard balloon angioplasty; inthe Coronary Angioplasty versus Excisional Atherectomy Trial,18this rate was 66.1 percent one year after balloon angioplastyand 63.5 percent after directional coronary atherectomy. Thefavorable clinical outcome noted at one year in the presentstudy remained at three years (74.6 percent event-free survival).Schömig et al. reported a similarly slow decline in event-freesurvival during the period from one to two years after Palmaz–Schatzcoronary stenting.5 The low rate of events beyond one year associatedwith coronary stenting compared well with that reported forballoon coronary angioplasty.17,19 In accordance with the favorablelong-term clinical outcome, serial quantitative coronary angiographyperformed for up to three years demonstrated no further declinein minimal luminal diameter during the period six months aftercoronary stenting, a finding similar to those of previous studieswith follow-up periods of up to one year.20,21 The length ofthis period free of restenosis compared well with those we observedwith balloon coronary angioplasty.22 Thus, it is unlikely thatcoronary stenting simply delayed clinical restenosis insteadof preventing it. Although we noticed the formation of an aneurysmin one patient, we did not observe any other potentially deleteriousangiographic findings suggestive of late migration of stents,metal fatigue, or endarteritis.
This study demonstrated late regression of lesions more thansix months after coronary stenting, as detected by well-validatedquantitative coronary angiography. Restenosis inside the stenthas been reported to be due to neointimal hyperplasia in studiesin animals23,24 and also in the autopsy report of a human2 andin a study using intravascular ultrasonography.25 Schatz etal.23 demonstrated regression of intimal hyperplasia insidethe stent over time in a study in animals. In a study of diseasein humans, we showed a decrease in the extracellular matrixof the newly proliferating intima and subsequent fibrotic changeduring the first two to three years after balloon angioplasty.26Therefore, fibrotic maturation of the intimal hyperplasia insidethe stent may be one of the mechanisms of the observed improvementin the lumen at three years.
We could not address the issue of changes in the diameter ofthe stent over time as evidence of the compression or expansionof the stent itself, because the extremely radiolucent natureof the Palmaz–Schatz stent precluded accurate angiographicquantitation of stent diameter in most patients. However, arecent serial study using intravascular ultrasonography revealedno significant change in the cross-sectional area of the metallicslotted-tube stent during four months of follow-up after implantation.27It is unlikely, therefore, that changes in the diameter of astent play an important part in either restenosis or late regressionof the lesion.
In this study, late increases in luminal diameter (during theperiod from six months to three years after implantation) weresignificantly correlated with early decreases in diameter (duringthe period from immediately after the procedure to the six-monthfollow-up), suggesting that the earlier intimal hyperplasiaoccurs, the greater the potential for late regression. Thesedata imply that when a relatively small lumen is found six monthsafter coronary stenting, it may safely be observed, withoutrepeated coronary intervention, unless the patient is highlysymptomatic. Asymptomatic restenosis has been reported to occurfrequently, with a good prognosis, in patients with negativeexercise tests after balloon angioplasty,28 directional coronaryatherectomy, or Palmaz–Schatz coronary-artery stenting.29Given the low incidence of angiographically detected restenosis,the need for angiographic follow-up after each implantationof a single stent in a native coronary artery must be seriouslyquestioned in clinical practice.
This study has several important limitations. This series ofpatients represented our very early experience with stent implantation,and current modifications of the technique (with high-pressuredilatation at the end of the procedure) and the regimen of anticoagulanttherapy (with the use of more potent antiplatelet agents) wouldprobably improve the clinical outcome. On the other hand, extendingthe application of coronary-artery stenting to longer lesions,smaller arteries, or both might produce a different clinicaland angiographic outcome. Our study did not include a comparisongroup of patients who underwent standard balloon angioplastywithout stenting. In comparing our follow-up data with thoseof studies using historical controls to evaluate other interventions,one must keep in mind the differences in base-line characteristics.Also, although a well-validated system of quantitative coronaryangiography was used, the analysis was not done in a core laboratory.Finally, although not all the patients returned for study afterthree years, base-line characteristics and quantitative angiographicvariables measured after six months were similar between thegroup that had angiography at three years and the group thatdid not. Despite these limitations of the study, the safetyand efficacy of the implantation of a single stent in a nativecoronary artery appeared to persist for at least three years.
We are indebted to the staff members of the cardiac catheterizationlaboratory and to Miss Tamami Shimizu for secretarial assistance.
Source Information
From the Department of Cardiology, Kokura Memorial Hospital, 1-1 Kifune-machi, Kokurakita-ku, Kitakyushu, 802, Japan, where reprint requests should be addressed to Dr. Nobuyoshi.
References
Sigwart U, Puel J, Mirkovitch V, Joffre F, Kappenberger L. Intravascular stents to prevent occlusion and restenosis after transluminal angioplasty. N Engl J Med 1987;316:701-706. [Abstract]
Schatz RA, Baim DS, Leon M, et al. Clinical experience with the Palmaz-Schatz coronary stent: initial results of a multicenter study. Circulation 1991;83:148-161. [Free Full Text]
Herrmann NC, Buchbinder M, Clemen MW, et al. Emergent use of balloon-expandable coronary artery stenting for failed percutaneous transluminal coronary angioplasty. Circulation 1992;86:812-819. [Free Full Text]
Roubin GS, Cannon AD, Agrawal SK, et al. Intracoronary stenting for acute and threatened closure complicating percutaneous transluminal coronary angioplasty. Circulation 1992;85:916-927. [Free Full Text]
Schömig A, Kastrati A, Mudra H, et al. Four-year experience with Palmaz-Schatz stenting in coronary angioplasty complicated by dissection with threatened or present vessel closure. Circulation 1994;90:2716-2724. [Free Full Text]
Carrozza JP Jr, Kuntz RE, Levine MJ, et al. Angiographic and clinical outcome of intracoronary stenting: immediate and long-term results from a large single-center experience. J Am Coll Cardiol 1992;20:328-337. [Abstract]
Ellis SG, Savage M, Fischman D, et al. Restenosis after placement of Palmaz-Schatz stents in native coronary arteries: initial results of a multicenter experience. Circulation 1992;86:1836-1844. [Free Full Text]
Kimura T, Nosaka H, Yokoi H, Iwabuchi M, Nobuyoshi M. Serial angiographic follow-up after Palmaz-Schatz stent implantation: comparison with conventional balloon angioplasty. J Am Coll Cardiol 1993;21:1557-1563. [Abstract]
Fischman DL, Leon MB, Baim DS, et al. A randomized comparison of coronary-stent placement and balloon angioplasty in the treatment of coronary artery disease. N Engl J Med 1994;331:496-501. [Free Full Text]
Serruys PW, de Jaegere P, Kiemeneij F, et al. A comparison of balloon-expandable-stent implantation with balloon angioplasty in patients with coronary artery disease. N Engl J Med 1994;331:489-495. [Free Full Text]
Nakamura S, Colombo A, Gaglione A, et al. Intracoronary ultrasound observations during stent implantation. Circulation 1994;89:2026-2034. [Free Full Text]
Colombo A, Hall P, Nakamura S, et al. Intracoronary stenting without anticoagulation accomplished with intravascular ultrasound guidance. Circulation 1995;91:1676-1688. [Free Full Text]
Topol EJ. Caveats about elective coronary stenting. N Engl J Med 1994;331:539-541. [Free Full Text]
The TIMI Study Group. The Thrombolysis In Myocardial Infarction (TIMI) trial: Phase 1 findings. N Engl J Med 1985;312:932-936. [Medline]
Serruys PW, Foley DP, de Feyter PJ, eds. Quantitative coronary angiography in clinical practice. Dordrecht, the Netherlands: Kluwer Academic, 1994.
Matthews DE, Farewell VT. Using and understanding medical statistics. 2nd ed. Basel, Switzerland: Karger, 1988.
Detre KM, Holmes DR Jr, Holubkov R, et al. Incidence and consequences of periprocedural occlusion: the 1985-1986 National Heart, Lung, and Blood Institute Percutaneous Transluminal Coronary Angioplasty Registry. Circulation 1990;82:739-750. [Free Full Text]
Elliott JM, Berdan LG, Holmes DR, et al. One-year follow-up in the Coronary Angioplasty Versus Excisional Atherectomy Trial (CAVEAT I). Circulation 1995;91:2158-2166. [Free Full Text]
King SB III, Schlumpf M. Ten-year completed follow-up of percutaneous transluminal coronary angioplasty: the early Zurich experience. J Am Coll Cardiol 1993;22:353-360. [Abstract]
Kastrati A, Schömig A, Dietz R, Neumann FJ, Richardt G. Time course of restenosis during the first year after emergency coronary stenting. Circulation 1993;87:1498-1505. [Free Full Text]
Savage MP, Fischman DL, Schatz RA, et al. Long-term angiographic and clinical outcome after implantation of a balloon-expandable stent in the native coronary circulation. J Am Coll Cardiol 1994;24:1207-1212. [Abstract]
Nobuyoshi M, Kimura T, Nosaka H, et al. Restenosis after successful percutaneous transluminal coronary angioplasty: serial angiographic follow-up of 229 patients. J Am Coll Cardiol 1988;12:616-623. [Abstract]
Schatz RA, Palmaz JC, Tio FO, Garcia F, Garcia O, Reuter SR. Balloon-expandable intracoronary stents in the adult dog. Circulation 1987;76:450-457. [Free Full Text]
White CJ, Ramee SR, Banks AK, Mesa JE, Chokshi S, Isner JM. A new balloon-expandable tantalum coil stent: angiographic patency and histologic findings in an atherogenic swine model. J Am Coll Cardiol 1992;19:870-876. [Abstract]
Mintz GS, Pichard AD, Kent KM, et al. Endovascular stents reduce restenosis by eliminating geometric arterial remodeling: a serial intravascular ultrasound study. J Am Coll Cardiol 1995;25:36A-36A.abstract
Nobuyoshi M, Kimura T, Ohishi H, et al. Restenosis after percutaneous transluminal coronary angioplasty: pathologic observations in 20 patients. J Am Coll Cardiol 1991;17:433-439. [Abstract]
Painter JA, Wong SC, Mintz GS, Popma JJ, Pichard AD, Satler LF. Does stent recoil contribute to restenosis? A serial intravascular ultrasound study. Circulation 1994;90:I-163.abstract
Hernández RA, Macaya C, Iñiguez A, et al. Midterm outcome of patients with asymptomatic restenosis after coronary balloon angioplasty. J Am Coll Cardiol 1992;19:1402-1409. [Abstract]
Gordon PC, Friedrich SP, Piana RN, et al. Is 40% to 70% diameter narrowing at the site of previous stenting or directional coronary atherectomy clinically significant? Am J Cardiol 1994;74:26-32. [CrossRef][Medline]
Brodie, B. R., Wilson, H., Stuckey, T., Nussbaum, M., Laurent, S., Bradshaw, B., Humphrey, A., Metzger, C., Hermiller, J., Krainin, F., Juk, S., Cheek, B., Duffy, P., Simonton, C. A., for the STENT Group,
(2009). Outcomes With Drug-Eluting Versus Bare-Metal Stents in Saphenous Vein Graft Intervention: Results From the STENT (Strategic Transcatheter Evaluation of New Therapies) Group. J Am Coll Cardiol Intv
2: 1105-1112
[Abstract][Full Text]
Byrne, R. A., Kastrati, A., Kufner, S., Massberg, S., Birkmeier, K. A., Laugwitz, K.-L., Schulz, S., Pache, J., Fusaro, M., Seyfarth, M., Schomig, A., Mehilli, J., for the Intracoronary Stenting and Angiographic Re,
(2009). Randomized, non-inferiority trial of three limus agent-eluting stents with different polymer coatings: the Intracoronary Stenting and Angiographic Results: Test Efficacy of 3 Limus-Eluting Stents (ISAR-TEST-4) Trial. Eur Heart J
30: 2441-2449
[Abstract][Full Text]
Byrne, R A, Kufner, S, Tiroch, K, Massberg, S, Laugwitz, K-L, Birkmeier, A, Schulz, S, Mehilli, J, for the Intracoronary Stenting and Angiographic Re,
(2009). Randomised trial of three rapamycin-eluting stents with different coating strategies for the reduction of coronary restenosis: 2-year follow-up results. Heart
95: 1489-1494
[Abstract][Full Text]
Yokoyama, S., Takano, M., Yamamoto, M., Inami, S., Sakai, S., Okamatsu, K., Okuni, S., Seimiya, K., Murakami, D., Ohba, T., Uemura, R., Seino, Y., Hata, N., Mizuno, K.
(2009). Extended Follow-Up by Serial Angioscopic Observation for Bare-Metal Stents in Native Coronary Arteries: From Healing Response to Atherosclerotic Transformation of Neointima. Circ Cardiovasc Interv
2: 205-212
[Abstract][Full Text]
Byrne, R. A., Iijima, R., Mehilli, J., Pinieck, S., Bruskina, O., Schomig, A., Kastrati, A.
(2009). Durability of Antirestenotic Efficacy in Drug-Eluting Stents With and Without Permanent Polymer. J Am Coll Cardiol Intv
2: 291-299
[Abstract][Full Text]
Finn, A. V., Nakazawa, G., Kolodgie, F. D., Virmani, R.
(2009). Temporal Course of Neointimal Formation After Drug-Eluting Stent Placement: Is Our Understanding of Restenosis Changing?. J Am Coll Cardiol Intv
2: 300-302
[Full Text]
Philpott, A. C. MD, Southern, D. A. MSc, Clement, F. M. PhD, Galbraith, P. D. BN MSc, Traboulsi, M. MD, Knudtson, M. L. MD, Ghali, W. A. MD, for the APPROACH Investigators,
(2009). Long-term outcomes of patients receiving drug-eluting stents. CMAJ
180: 167-174
[Abstract][Full Text]
Doi, H., Maehara, A., Mintz, G. S., Weissman, N. J., Yu, A., Wang, H., Mandinov, L., Popma, J. J., Ellis, S. G., Grube, E., Dawkins, K. D., Stone, G. W.
(2008). Impact of In-Stent Minimal Lumen Area at 9 Months Poststent Implantation on 3-Year Target Lesion Revascularization-Free Survival: A Serial Intravascular Ultrasound Analysis From the TAXUS IV, V, and VI Trials. Circ Cardiovasc Interv
1: 111-118
[Abstract][Full Text]
Garg, P., Cohen, D. J., Gaziano, T., Mauri, L.
(2008). Balancing the Risks of Restenosis and Stent Thrombosis in Bare-Metal Versus Drug-Eluting Stents: Results of a Decision Analytic Model. J Am Coll Cardiol
51: 1844-1853
[Abstract][Full Text]
Hannan, E. L., Racz, M., Holmes, D. R., Walford, G., Sharma, S., Katz, S., Jones, R. H., King, S. B. III
(2008). Comparison of Coronary Artery Stenting Outcomes in the Eras Before and After the Introduction of Drug-Eluting Stents. Circulation
117: 2071-2078
[Abstract][Full Text]
Wilson, J. M., Willerson, J. T.
(2008). Myocardial Revascularization with Percutaneous Devices. Card Surg Adult
3: 573-598
[Full Text]
Awata, M., Kotani, J.-i., Uematsu, M., Morozumi, T., Watanabe, T., Onishi, T., Iida, O., Sera, F., Nanto, S., Hori, M., Nagata, S.
(2007). Serial Angioscopic Evidence of Incomplete Neointimal Coverage After Sirolimus-Eluting Stent Implantation: Comparison With Bare-Metal Stents. Circulation
116: 910-916
[Abstract][Full Text]
Ryan, J., Cohen, D. J.
(2006). Are Drug-Eluting Stents Cost-Effective?: It Depends on Whom You Ask. Circulation
114: 1736-1744
[Full Text]
Ozdemir, R., Sezgin, A. T., Barutcu, I., Topal, E., Gullu, H., Acikgoz, N.
(2006). Comparison of Direct Stenting Versus Conventional Stent Implantation on Blood Flow in Patients With ST-Segment Elevation Myocardial Infarction. ANGIOLOGY
57: 453-458
[Abstract]
Valgimigli, M., Malagutti, P., van Mieghem, C. A.G., Vaina, S., Ligthart, J. M., Sianos, G., Serruys, P. W.
(2006). Persistence of Neointimal Growth 12 Months After Intervention and Occurrence of Delayed Restenosis in Patients With Left Main Coronary Artery Disease Treated With Drug-Eluting Stents. J Am Coll Cardiol
47: 1491-1494
[Full Text]
Aoki, J., Colombo, A., Dudek, D., Banning, A. P., Drzewiecki, J., Zmudka, K., Schiele, F., Russell, M. E., Koglin, J., Serruys, P. W., for the TAXUS II Study Group,
(2005). Peristent Remodeling and Neointimal Suppression 2 Years After Polymer-Based, Paclitaxel-Eluting Stent Implantation: Insights From Serial Intravascular Ultrasound Analysis in the TAXUS II Study. Circulation
112: 3876-3883
[Abstract][Full Text]
Wessely, R., Kastrati, A., Schomig, A.
(2005). Late Restenosis in Patients Receiving a Polymer-Coated Sirolimus-Eluting Stent. ANN INTERN MED
143: 392-394
[Full Text]
Windecker, S., Remondino, A., Eberli, F. R., Juni, P., Raber, L., Wenaweser, P., Togni, M., Billinger, M., Tuller, D., Seiler, C., Roffi, M., Corti, R., Sutsch, G., Maier, W., Luscher, T., Hess, O. M., Egger, M., Meier, B.
(2005). Sirolimus-Eluting and Paclitaxel-Eluting Stents for Coronary Revascularization. NEJM
353: 653-662
[Abstract][Full Text]
Butany, J, Carmichael, K, Leong, S W, Collins, M J
(2005). Coronary artery stents: identification and evaluation. J. Clin. Pathol.
58: 795-804
[Abstract][Full Text]
Wenaweser, P., Rey, C., Eberli, F. R., Togni, M., Tuller, D., Locher, S., Remondino, A., Seiler, C., Hess, O. M., Meier, B., Windecker, S.
(2005). Stent thrombosis following bare-metal stent implantation: success of emergency percutaneous coronary intervention and predictors of adverse outcome. Eur Heart J
26: 1180-1187
[Abstract][Full Text]
Ellis, S. G., Popma, J. J., Lasala, J. M., Koglin, J. J., Cox, D. A., Hermiller, J., O'Shaughnessy, C., Mann, J. T., Turco, M., Caputo, R., Bergin, P., Greenberg, J., Stone, G. W.
(2005). Relationship between angiographic late loss and target lesion revascularization after coronary stent implantation: Analysis from the TAXUS-IV trial. J Am Coll Cardiol
45: 1193-1200
[Abstract][Full Text]
Falcoz, P.-E., Chocron, S., Binquet, C., Stoica, L., Kaili, D., Quantin, C., Etievent, J.-P.
(2005). Revascularization of the Right Coronary Artery: Grafting or Percutaneous Coronary Intervention?. Ann. Thorac. Surg.
79: 1232-1239
[Abstract][Full Text]
Mauri, L., Orav, E. J., O'Malley, A. J., Moses, J. W., Leon, M. B., Holmes, D. R. Jr, Teirstein, P. S., Schofer, J., Breithardt, G., Cutlip, D. E., Kereiakes, D. J., Shi, C., Firth, B. G., Donohoe, D. J., Kuntz, R. E.
(2005). Relationship of Late Loss in Lumen Diameter to Coronary Restenosis in Sirolimus-Eluting Stents. Circulation
111: 321-327
[Abstract][Full Text]
Sonmez, K., Turan, F., Gencbay, M., Degertekin, M., Duran, N. E.
(2004). Long-term (>3 Years) Clinical and Angiographic Outcomes of Coronary Multilink Stent Implantations: A Single Center Experience. ANGIOLOGY
55: 469-477
[Abstract]
Farb, A., Kolodgie, F. D., Hwang, J.-Y., Burke, A. P., Tefera, K., Weber, D. K., Wight, T. N., Virmani, R.
(2004). Extracellular Matrix Changes in Stented Human Coronary Arteries. Circulation
110: 940-947
[Abstract][Full Text]
Kim, J K, Ahn, J Y, Lee, B H, Chung, Y S, Chung, S S, Kim, O J, Kim, W C, Joo, J Y
(2004). Elective stenting for symptomatic middle cerebral artery stenosis presenting as transient ischaemic deficits or stroke attacks: short term arteriographical and clinical outcome. J. Neurol. Neurosurg. Psychiatry
75: 847-851
[Abstract][Full Text]
Versaci, F, Gaspardone, A, Tomai, F, Proietti, I, Ghini, A S, Altamura, L, Ando, G, Crea, F, Gioffre, P A, Chiariello, L
(2004). A comparison of coronary artery stenting with angioplasty for isolated stenosis of the proximal left anterior descending coronary artery: five year clinical follow up. Heart
90: 672-675
[Abstract][Full Text]
Hayashi, T, Kimura, A, Ishikawa, K
(2004). Acute myocardial infarction caused by thrombotic occlusion at a stent site two years after conventional stent implantation. Heart
90: e26-e26
[Abstract][Full Text]
Moses, J. W., Leon, M. B., Popma, J. J., Fitzgerald, P. J., Holmes, D. R., O'Shaughnessy, C., Caputo, R. P., Kereiakes, D. J., Williams, D. O., Teirstein, P. S., Jaeger, J. L., Kuntz, R. E., the SIRIUS Investigators,
(2003). Sirolimus-Eluting Stents versus Standard Stents in Patients with Stenosis in a Native Coronary Artery. NEJM
349: 1315-1323
[Abstract][Full Text]
Rubartelli, P., Verna, E., Niccoli, L., Giachero, C., Zimarino, M., Bernardi, G., Vassanelli, C., Campolo, L., Martuscelli, E., Gruppo Italiano di Studio sullo Stent nelle Occlus,
(2003). Coronary stent implantation is superior to balloon angioplasty for chronic coronary occlusions: Six-year clinical follow-up of the GISSOC trial. J Am Coll Cardiol
41: 1488-1492
[Abstract][Full Text]
Sousa, J. E., Costa, M. A., Sousa, A. G.M.R., Abizaid, A. C., Seixas, A. C., Abizaid, A. S., Feres, F., Mattos, L. A., Falotico, R., Jaeger, J., Popma, J. J., Serruys, P. W.
(2003). Two-Year Angiographic and Intravascular Ultrasound Follow-Up After Implantation of Sirolimus-Eluting Stents in Human Coronary Arteries. Circulation
107: 381-383
[Abstract][Full Text]
Cutlip, D. E., Chauhan, M. S., Baim, D. S., Ho, K. K. L., Popma, J. J., Carrozza, J. P., Cohen, D. J., Kuntz, R. E.
(2002). Clinical restenosis after coronary stenting: perspectives from multicenter clinical trials. J Am Coll Cardiol
40: 2082-2089
[Abstract][Full Text]
Miketic, S, Carlsson, J, Tebbe, U
(2002). Clinical and angiographic outcome after conventional angioplasty with optional stent implantation compared with direct stenting without predilatation. Heart
88: 622-626
[Abstract][Full Text]
Degertekin, M., Serruys, P. W., Foley, D. P., Tanabe, K., Regar, E., Vos, J., Smits, P. C., van der Giessen, W. J., van den Brand, M., de Feyter, P., Popma, J. J.
(2002). Persistent Inhibition of Neointimal Hyperplasia After Sirolimus-Eluting Stent Implantation: Long-Term (Up to 2 Years) Clinical, Angiographic, and Intravascular Ultrasound Follow-Up. Circulation
106: 1610-1613
[Abstract][Full Text]
Kimura, T., Abe, K., Shizuta, S., Odashiro, K., Yoshida, Y., Sakai, K., Kaitani, K., Inoue, K., Nakagawa, Y., Yokoi, H., Iwabuchi, M., Hamasaki, N., Nosaka, H., Nobuyoshi, M.
(2002). Long-Term Clinical and Angiographic Follow-Up After Coronary Stent Placement in Native Coronary Arteries. Circulation
105: 2986-2991
[Abstract][Full Text]
Maier, W., Windecker, S., Kung, A., Lutolf, R., Eberli, F. R., Meier, B., Hess, O. M.
(2002). Exercise-Induced Coronary Artery Vasodilation Is Not Impaired by Stent Placement. Circulation
105: 2373-2377
[Abstract][Full Text]
Sasao, H., Endo, A., Hasegawa, T., Ichikawa, Y., Noda, R., Oimatsu, H., Takada, T.
(2002). Long-Term Follow-up After Coronary Stent Implantation in Patients with Coronary Artery Disease. ANGIOLOGY
53: 149-156
[Abstract]
Park, S.-J., Hong, M.-K., Lee, C. W., Kim, J.-J., Song, J.-K., Kang, D.-H., Park, S.-W., Mintz, G. S.
(2001). Elective stenting of unprotected left main coronary artery stenosis: Effect of debulking before stenting and intravascular ultrasound guidance. J Am Coll Cardiol
38: 1054-1060
[Abstract][Full Text]
van Domburg, R.T, Foley, D.P, de Feyter, P.J, van der Giessen, W, van den Brand, M.J.B.M, Serruys, P.W
(2001). Long-term clinical outcome after coronary balloon angioplasty. Identification of a population at low risk of recurrent events during 17 years of follow-up. Eur Heart J
22: 934-941
[Abstract]
Kobayashi, Y., Honda, Y., Christie, L. G., Teirstein, P. S., Bailey, S. R., Brown, C. L. III, Matthews, R. V., De Franco, A. C., Schwartz, R. S., Goldberg, S., Popma, J. J., Yock, P. G., Fitzgerald, P. J.
(2001). Long-term vessel response to a self-expanding coronary stent: a serial volumetric intravascular ultrasound analysis from the ASSURE trial. J Am Coll Cardiol
37: 1329-1334
[Abstract][Full Text]
SCHIELE, F.
(2001). The "angioplastically correct" follow up strategy after stent implantation. Heart
85: 363-364
[Full Text]
Kay, I. P., Wardeh, A. J., Kozuma, K., Foley, D. P., Knook, A. H. M., Thury, A., Sianos, G., van der Giessen, W. J., Levendag, P. C., Serruys, P. W.
(2001). Radioactive Stents Delay but Do Not Prevent In-Stent Neointimal Hyperplasia. Circulation
103: 14-17
[Abstract][Full Text]
De Feyter, P.J., Foley, D.
(2000). Coronary stent implantation: a panacea for the interventional cardiologist?. Eur Heart J
21: 1719-1726
Hoffmann, R., Mintz, G.S.
(2000). Coronary in-stent restenosis--predictors, treatment and prevention. Eur Heart J
21: 1739-1749
Colombo, A., Karvouni, E.
(2000). Biodegradable Stents : "Fulfilling the Mission and Stepping Away". Circulation
102: 371-373
[Full Text]
Tamai, H., Igaki, K., Kyo, E., Kosuga, K., Kawashima, A., Matsui, S., Komori, H., Tsuji, T., Motohara, S., Uehata, H.
(2000). Initial and 6-Month Results of Biodegradable Poly-l-Lactic Acid Coronary Stents in Humans. Circulation
102: 399-404
[Abstract][Full Text]
Kuntz, R. E., Baim, D. S.
(2000). Prevention of Coronary Restenosis : The Evolving Evidence Base for Radiation Therapy. Circulation
101: 2130-2133
[Full Text]
Windecker, S., Meier, B.
(2000). CORONARY DISEASE: Intervention in coronary artery disease. Heart
83: 481-481
[Full Text]
Mori, T., Kazita, K., Chokyu, K., Mima, T., Mori, K.
(2000). Short-Term Arteriographic and Clinical Outcome after Cerebral Angioplasty and Stenting for Intracranial Vertebrobasilar and Carotid AtheroscleroticOcclusive Disease. Am. J. Neuroradiol.
21: 249-254
[Abstract][Full Text]
Yano, M., Kojima, S., Sugi, T., Matsumoto, Y., Kuramochi, M., Yoshitomi, Y.
(2000). Long-Term Follow-up of Primary Stenting with Coil Stent in Acute Myocardial Infarction. ANGIOLOGY
51: 107-114
[Abstract]
Teirstein, P. S., Massullo, V., Jani, S., Popma, J. J., Russo, R. J., Schatz, R. A., Guarneri, E. M., Steuterman, S., Sirkin, K., Cloutier, D. A., Leon, M. B., Tripuraneni, P.
(2000). Three-Year Clinical and Angiographic Follow-Up After Intracoronary Radiation : Results of a Randomized Clinical Trial. Circulation
101: 360-365
[Abstract][Full Text]
Ishibashi-Ueda, H., Yutani, C., Imakita, M., Kuribayashi, S., Takamiya, M., Uchida, H., Kichikawa, K., Suzuki, T., Ishibashi-Ueda, H.
(1999). Histologic Comparison of Coronary and Iliac Atherectomy Tissue from Cases of In-Stent Restenosis. ANGIOLOGY
50: 977-987
[Abstract]
Ruygrok, P. N., Melkert, R., Morel, M.-A. M., Ormiston, J. A., Bar, F. W., Fernandez-Aviles, F., Suryapranata, H., Dawkins, K. D., Hanet, C., Serruys, P. W., on behalf of the Benestent II Investigators Cardia,
(1999). Does angiography six months after coronary intervention influence management and outcome?. J Am Coll Cardiol
34: 1507-1511
[Abstract][Full Text]
Kleemann, A., Eckert, S., von Eckardstein, A., Lepper, W., Schernikau, U., Gleichmann, U., Hanrath, P., Fleck, E., Neiss, A., Kerber, S., Assmann, G., Breithardt, G., the CLAPT Study Group,
(1999). Effects of lovastatin on progression of non-dilated and dilated coronary segments and on restenosis in patients after PTCA. The Cholesterol Lowering Atherosclerosis PTCA Trial (CLAPT). Eur Heart J
20: 1393-1406
[Abstract]
Tsuchikane, E., Sumitsuji, S., Awata, N., Nakamura, T., Kobayashi, T., Izumi, M., Otsuji, S., Tateyama, H., Sakurai, M., Kobayashi, T.
(1999). Final results of the STent versus directional coronary Atherectomy Randomized Trial (START). J Am Coll Cardiol
34: 1050-1057
[Abstract][Full Text]
Carmichael, P., Carmichael, A. R
(1999). Current concepts: Atherosclerotic renal artery stenosis: from diagnosis to treatment. Postgrad. Med. J.
75: 527-536
[Abstract][Full Text]
Ferrer, F., Moraleda, J. M., Vicente, V., LoGerfo, F. W., Wohl, V. R., Hecht, E., Shaughnessy, K., Leon, M. B., Dangas, G., Erbel, R., Haude, M., The Restenosis Stent Study Group, , Topol, E. J.
(1999). Antithrombotic Therapy after Coronary-Artery Stenting. NEJM
340: 1365-1368
[Full Text]
Stone, G. W., Brodie, B. R., Griffin, J. J., Costantini, C., Morice, M. C., St. Goar, F. G., Overlie, P. A., Popma, J. J., McDonnell, J., Jones, D., O'Neill, W. W., Grines, C. L.
(1999). Clinical and Angiographic Follow-Up After Primary Stenting in Acute Myocardial Infarction : The Primary Angioplasty in Myocardial Infarction (PAMI) Stent Pilot Trial. Circulation
99: 1548-1554
[Abstract][Full Text]
Gandhi, M. M, Dawkins, K. D
(1999). Fortnightly review: Intracoronary stents. BMJ
318: 650-653
[Full Text]
Hanekamp, C. E. E., Koolen, J. J., Pijls, N. H. J., Michels, H. R., Bonnier, H. J. R. M.
(1999). Comparison of Quantitative Coronary Angiography, Intravascular Ultrasound, and Coronary Pressure Measurement to Assess Optimum Stent Deployment. Circulation
99: 1015-1021
[Abstract][Full Text]
Kuntz, R. E.
(1999). Importance of Considering Atherosclerosis Progression When Choosing a Coronary Revascularization Strategy : The Diabetes–Percutaneous Transluminal Coronary Angioplasty Dilemma. Circulation
99: 847-851
[Full Text]
Heckenkamp, J., Lamuraglia, G. M.
(1999). Intimal Hyperplasia, Arterial Remodeling, and Restenosis: An Overview. PERSPECT VASC SURG ENDOVASC THER
11: 71-94
[Abstract]
Corcos, T., Favereau, X., Guerin, Y., Narins, C. R., Topol, E. J., Holmes, D. R. Jr
(1998). A Call for Professional Stenting: The Balloon Is Dead and Buried! • Response. Circulation
98: 2644-2645
[Full Text]
Holmes, D. R. Jr., Hirshfeld, J. Jr., Faxon, D., Vlietstra, R., Jacobs, A., King, S. B. III, Bashore, T. M., Bridges, N. D., Higgins, C. B., Hiratzka, L. F., Little, W. C., Magorien, R. D., Nocero, M. A. Jr., Oesterle, S., Vogel, R. A., Forrester, J. S., Douglas, P. S., Faxon, D. P., Fisher, J. D., Gibbons, R. J., Halperin, J. L., Hutter, A. M. Jr., Hochman, J. S., Kaul, S., Weintraub, W. S., Winters, W. L. Jr., Wolk, M. J.
(1998). ACC expert consensus document on coronary artery stents: Document of the American College of Cardiology. J Am Coll Cardiol
32: 1471-1482
[Full Text]
Sirnes, P. A., Golf, S., Myreng, Y., Molstad, P., Albertsson, P., Mangschau, A., Endresen, K., Kjekshus, J.
(1998). Sustained benefit of stenting chronic coronary occlusion: long-term clinical follow-up of the Stenting in Chronic Coronary Occlusion (SICCO) study. J Am Coll Cardiol
32: 305-310
[Abstract][Full Text]
Asakura, M., Ueda, Y., Nanto, S., Hirayama, A., Adachi, T., Kitakaze, M., Hori, M., Kodama, K.
(1998). Remodeling of In-Stent Neointima, Which Became Thinner and Transparent Over 3 Years : Serial Angiographic and Angioscopic Follow-up. Circulation
97: 2003-2006
[Abstract][Full Text]
Narins, C. R., Holmes, D. R. Jr, Topol, E. J.
(1998). A Call for Provisional Stenting : The Balloon Is Back!. Circulation
97: 1298-1305
[Full Text]
Calafiore, A. M., Giammarco, G. D., Teodori, G., Gallina, S., Maddestra, N., Paloscia, L., Scipioni, G., Iovino, T., Contini, M., Vitolla, G.
(1998). Midterm results after minimally invasive coronary surgery (last operation). J. Thorac. Cardiovasc. Surg.
115: 763-771
[Abstract][Full Text]
Baek, S., March, K. L.
(1998). Gene Therapy for Restenosis : Getting Nearer the Heart of the Matter. Circ. Res.
82: 295-305
[Abstract][Full Text]
Laruelle, C J J, Brueren, G B R, Ernst, S M P G, Bal, E T, Mast, G E, Suttorp, M-J, de la Rivière, A B., Plokker, T H W
(1998). Stenting of "unprotected" left main coronary artery stenoses: early and late results. Heart
79: 148-152
[Abstract][Full Text]
Ormiston, J. A., Stewart, F. M., Roche, A. H. G., Webber, B. J., Whitlock, R. M. L., Webster, M. W. I.
(1997). Late Regression of the Dilated Site After Coronary Angioplasty : A 5-Year Quantitative Angiographic Study. Circulation
96: 468-474
[Abstract][Full Text]
Kimura, T., Kaburagi, S., Tamura, T., Yokoi, H., Nakagawa, Y., Yokoi, H., Hamasaki, N., Nosaka, H., Nobuyoshi, M., Mintz, G. S., Popma, J. J., Leon, M. B.
(1997). Remodeling of Human Coronary Arteries Undergoing Coronary Angioplasty or Atherectomy. Circulation
96: 475-483
[Abstract][Full Text]
Bittl, J. A.
(1996). Advances in Coronary Angioplasty. NEJM
335: 1290-1302
[Full Text]
Fischell, T. A.
(1996). Polymer Coatings for Stents: Can We Judge a Stent by Its Cover?. Circulation
94: 1494-1495
[Full Text]
Edelman, E. R., Rogers, C.
(1996). Hoop Dreams: Stents Without Restenosis. Circulation
94: 1199-1202
[Full Text]
Holubkov, R., Detre, K. M., Kimura, T., Nobuyoshi, M.
(1996). Coronary-Artery Stenting. NEJM
335: 61-61
[Full Text]
Previous
).