Circulation. 1998;97:1298-1305
(Circulation. 1998;97:1298-1305.)
© 1998 American Heart Association, Inc.
A Call for Provisional Stenting
The Balloon Is Back!
Craig R. Narins, MD;
David R. Holmes, Jr, MD;
; Eric J. Topol, MD
From the Department of Cardiology and Joseph J. Jacobs Center for
Vascular Biology, The Cleveland Clinic Foundation, Cleveland, Ohio; and the
Division of Cardiovascular Diseases, Mayo Clinic and Mayo Foundation,
Rochester, Minn.
Correspondence to Eric J. Topol, MD, Department of Cardiology, F25, The Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195. E-mail topole@cesmtp.ccf.org
Key Words: stents • balloon • revascularization
 |
Introduction
|
|---|
During the past 20
years, the equipment used to perform percutaneous
coronary revascularization has undergone a
dramatic transformation from simple balloon dilatation catheters to
sophisticated mechanical devices and endoprostheses. The impetus for
this evolution in technology was initially a byproduct of
suboptimal immediate and long-term results obtained with standard
balloon angioplasty. New techniques, including directional and
rotational atherectomy, have resulted in improved procedural success
rates, especially for more complex lesion subtypes, although their
ability to curtail restenosis remains
controversial.1 2 Intracoronary stents
have had a dramatic impact on reduction of the incidence of acute
complications after failed balloon angioplasty and represent
the only currently available strategy shown to limit both clinical and
angiographic restenosis.3 4 5 6 7 8 9 10 11 12 Based on
these advantages, stent implantation is used in approximately half of
all percutaneous interventions in the United States.
However, despite their proven benefits, coronary stents
continue to be accompanied by several theoretical and practical
limitations: they are costly, typically associated with a more marked
degree of neointimal formation than balloon angioplasty,
and difficult to use with some lesion subsets such as bifurcation
stenoses, and they have engendered the new and
difficult-to-treat entity of in-stent restenosis.
Although the major focus in the field of interventional
cardiology over the past decade has been on the
development of new devices and adjunctive pharmacological therapies,
the short- and long-term success rates after standard balloon
angioplasty have improved significantly. Part of the improvement is
likely a manifestation of enhanced operator experience and better
equipment, but the results of balloon angioplasty have . . . [Full Text of this Article]
This article has been cited by other articles:
|
|
|
|
 
L. T. Newsome, M. A. Kutcher, and R. L. Royster
Coronary Artery Stents: Part I. Evolution of Percutaneous Coronary Intervention
Anesth. Analg.,
August 1, 2008;
107(2):
552 - 569.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. T. Boll, E. M. Merkle, E. K. Paulson, and T. R. Fleiter
Coronary Stent Patency: Dual-Energy Multidetector CT Assessment in a Pilot Study with Anthropomorphic Phantom
Radiology,
June 1, 2008;
247(3):
687 - 695.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. Alvarez Jr and N. K. Kapur
Drug Eluting Stent Technology: A Paradigm Shift in the Treatment and Prevention of Restenosis
Journal of Pharmacy Practice,
December 1, 2005;
18(6):
461 - 478.
[Abstract]
[PDF]
|
|
|
|
|
|
|
P. Agostoni, G. G.L. Biondi-Zoccai, G. L. Gasparini, M. Anselmi, G. Morando, M. Turri, A. Abbate, E. P. McFadden, C. Vassanelli, P. Zardini, et al.
Is bare-metal stenting superior to balloon angioplasty for small vessel coronary artery disease? Evidence from a meta-analysis of randomized trials
Eur. Heart J.,
May 1, 2005;
26(9):
881 - 889.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. R. Wilson, B. A. Vakili, W. Sherman, T. A. Sanborn, and D. L. Brown
Effect of Diabetes on Long-Term Mortality Following Contemporary Percutaneous Coronary Intervention: Analysis of 4,284 cases
Diabetes Care,
May 1, 2004;
27(5):
1137 - 1142.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. Perree, T. G. van Leeuwen, R. Kerindongo, J. A. E. Spaan, and E. VanBavel
Function and Structure of Pressurized and Perfused Porcine Carotid Arteries: Effects of in Vitro Balloon Angioplasty
Am. J. Pathol.,
November 1, 2003;
163(5):
1743 - 1750.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. A. Cox, G. W. Stone, C. L. Grines, T. Stuckey, D. J. Cohen, J. E. Tcheng, E. Garcia, G. Guagliumi, R. S. Iwaoka, M. Fahy, et al.
Outcomes of optimal or "stent-like"balloon angioplasty in acutemyocardial infarction: the CADILLAC trial
J. Am. Coll. Cardiol.,
September 17, 2003;
42(6):
971 - 977.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Hedman, J. Hartikainen, M. Syvanne, J. Stjernvall, A. Hedman, A. Kivela, E. Vanninen, H. Mussalo, E. Kauppila, S. Simula, et al.
Safety and Feasibility of Catheter-Based Local Intracoronary Vascular Endothelial Growth Factor Gene Transfer in the Prevention of Postangioplasty and In-Stent Restenosis and in the Treatment of Chronic Myocardial Ischemia: Phase II Results of the Kuopio Angiogenesis Trial (KAT)
Circulation,
June 3, 2003;
107(21):
2677 - 2683.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. Schiele, N. Meneveau, M. Gilard, J. Boschat, P. Commeau, L. P. Ming, P. Sewoke, M.-F. Seronde, M. Mercier, S. Gupta, et al.
Intravascular Ultrasound-Guided Balloon Angioplasty Compared With Stent: Immediate and 6-Month Results of the Multicenter, Randomized Balloon Equivalent to Stent Study (BEST)
Circulation,
February 4, 2003;
107(4):
545 - 551.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. O. Laukkanen, A. Kivela, T. Rissanen, J. Rutanen, M. K. Karkkainen, O. Leppanen, J. H. Brasen, and S. Yla-Herttuala
Adenovirus-Mediated Extracellular Superoxide Dismutase Gene Therapy Reduces Neointima Formation in Balloon-Denuded Rabbit Aorta
Circulation,
October 8, 2002;
106(15):
1999 - 2003.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. S. Zuckerbraun and E. Tzeng
Vascular Gene Therapy: A Reality of the 21st Century
Arch Surg,
July 1, 2002;
137(7):
854 - 861.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. vom Dahl, U. Dietz, P. K. Haager, S. Silber, L. Niccoli, H. J. Buettner, F. Schiele, M. Thomas, P. Commeau, D. R. Ramsdale, et al.
Rotational Atherectomy Does Not Reduce Recurrent In-Stent Restenosis: Results of the Angioplasty Versus Rotational Atherectomy for Treatment of Diffuse In-Stent Restenosis Trial (ARTIST)
Circulation,
February 5, 2002;
105(5):
583 - 588.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
H. Okura, M. Hayase, S. Shimodozono, H. N. Bonneau, P. G. Yock, and P. J. Fitzgerald
Impact of pre-interventional arterial remodeling on subsequent vessel behavior after balloon angioplasty: a serial intravascular ultrasound study
J. Am. Coll. Cardiol.,
December 1, 2001;
38(7):
2001 - 2005.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. H. Brasen, A. Kivela, K. Roser, T. T. Rissanen, M. Niemi, F. C. Luft, K. Donath, and S. Yla-Herttuala
Angiogenesis, Vascular Endothelial Growth Factor and Platelet-Derived Growth Factor-BB Expression, Iron Deposition, and Oxidation-Specific Epitopes in Stented Human Coronary Arteries
Arterioscler Thromb Vasc Biol,
November 1, 2001;
21(11):
1720 - 1726.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J.J Piek, E Boersma, M Voskuil, C di Mario, E Schroeder, C Vrints, P Probst, B de Bruyne, C Hanet, E Fleck, et al.
The immediate and long-term effect of optimal balloon angioplasty on the absolute coronary blood flow velocity reserve. A subanalysis of the DEBATE study
Eur. Heart J.,
September 2, 2001;
22(18):
1725 - 1732.
[Abstract]
[PDF]
|
|
|
|
|
|
|
W. J. Cantor, A. S. Hellkamp, E. D. Peterson, J. P. Zidar, P. A. Cowper, M. H. Sketch Jr, J. E. Tcheng, R. M. Califf, and E. M. Ohman
Achieving optimal results with standard balloon angioplasty: can baseline and angiographic variables predict stent-like outcomes?
J. Am. Coll. Cardiol.,
June 1, 2001;
37(7):
1883 - 1890.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S.-W Park, C.W Lee, M.-K Hong, J.-J Kim, G.-Y Cho, D.-Y Nah, and S.-J Park
Randomized comparison of coronary stenting with optimal balloon angioplasty for treatment of lesions in small coronary arteries
Eur. Heart J.,
November 1, 2000;
21(21):
1785 - 1789.
[Abstract]
[PDF]
|
|
|
|
|
|
|
P.W Serruys, J.N Hamburger, J Fajadet, M Haude, H Klues, R Seabra-Gomes, T Corcos, C Hamm, L Pizzuli, B Meier, et al.
Total occlusion trial with angioplasty by using laser guidewire. The TOTAL trial
Eur. Heart J.,
November 1, 2000;
21(21):
1797 - 1805.
[Abstract]
[PDF]
|
|
|
|
|
|
|
D S Fluck, P Chenu, P Mills, A Davies, J Street, E Paul, R Balcon, C A Layton, and W. T. Investigators' Group
Is provisional stenting the effective option? The WIDEST study (Wiktor stent in de novo stenosis)
Heart,
November 1, 2000;
84(5):
522 - 528.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
W. J. Cantor, E. D. Peterson, J. J. Popma, J. P. Zidar, M. H. Sketch Jr., J. E. Tcheng, and E. M. Ohman
Provisional stenting strategies: systematic overview and implications for clinical decision-making
J. Am. Coll. Cardiol.,
October 1, 2000;
36(4):
1142 - 1151.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C Schulz, R A Herrmann, C Beilharz, J Pasquantonio, and E Alt
Coronary stent symmetry and vascular injury determine experimental restenosis
Heart,
April 1, 2000;
83(4):
462 - 467.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
S. Windecker and B. Meier
CORONARY DISEASE: Intervention in coronary artery disease
Heart,
April 1, 2000;
83(4):
481 - 481.
[Full Text]
|
|
|
|
|
|
|
M. O Hiltunen, M. P Turunen, M. Laitinen, and S. Yla-Herttuala
Insights into the molecular pathogenesis of atherosclerosis and therapeutic strategies using gene transfer
Vascular Medicine,
February 1, 2000;
5(1):
41 - 48.
[Abstract]
[PDF]
|
|
|
|
|
|
|
C.J. Knight, N.P. Curzen, P.H. Groves, D.J. Patel, A.H. Goodall, C. Wright, D. Clarke, P.J. Oldershaw, and K.M. Fox
Stent implantation reduces restenosis in patients with suboptimal results following coronary angioplasty
Eur. Heart J.,
December 2, 1999;
20(24):
1783 - 1790.
[Abstract]
[PDF]
|
|
|
|
|
|
|
S. Windecker, W. Maier-Rudolph, T. Bonzel, G. Heyndrickx, J.M. Lablanche, M.C. Morice, V. Muhlberger, K.L. Neuhaus, F. Piscione, M. van den Brand, et al.
Interventional cardiology in Europe 1995
Eur. Heart J.,
April 1, 1999;
20(7):
484 - 495.
[Abstract]
[PDF]
|
|
|
|
|
|
|
G. J. W. Bech, N. H. J. Pijls, B. De Bruyne, K. H. Peels, H. R. Michels, H. J. R. M. Bonnier, and J. J. Koolen
Usefulness of Fractional Flow Reserve to Predict Clinical Outcome After Balloon Angioplasty
Circulation,
February 23, 1999;
99(7):
883 - 888.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Corcos, X. Favereau, Y. Guerin, C. R. Narins, E. J. Topol, and D. R. Holmes Jr
A Call for Professional Stenting: The Balloon Is Dead and Buried! • Response
Circulation,
December 8, 1998;
98(23):
2644 - 2645.
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. J. Topol
Coronary-Artery Stents -- Gauging, Gorging, and Gouging
N. Engl. J. Med.,
December 3, 1998;
339(23):
1702 - 1704.
[Full Text]
|
|
|
|
|
|
|
F. D. Loop
Coronary artery surgery: the end of the beginning
Eur. J. Cardiothorac. Surg.,
December 1, 1998;
14(6):
554 - 571.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. R. Holmes Jr., J. Hirshfeld Jr., D. Faxon, R. Vlietstra, A. Jacobs, S. B. King III, T. M. Bashore, N. D. Bridges, C. B. Higgins, L. F. Hiratzka, et al.
ACC expert consensus document on coronary artery stents: Document of the American College of Cardiology
J. Am. Coll. Cardiol.,
November 1, 1998;
32(5):
1471 - 1482.
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. J. Topol and P. W. Serruys
Frontiers in Interventional Cardiology
Circulation,
October 27, 1998;
98(17):
1802 - 1820.
[Full Text]
[PDF]
|
|
|
