Quantitative coronary angiographic assessment after placement of the new Wallstent in bypass grafts

While the Wallstent was the first stent ever implanted in a human coronary artery in March 1986, the prototype of the stent had a high incidence of acute thrombotic occlusions shortly after implantation. To overcome this limitation the design of the Wallstent was modified to reduce the degree of shortening and metallic burden and to lessen thrombogenicity. We report the results of the first group of patients to undergo implantation of the new Wallstent. Thirty-six Wallstents were electively deployed in coronary artery bypass grafts (CABG) in 30 patients. Initial angiographic success (< 50% residual diameter stenosis as determined by quantitative coronary angiography) was achieved in all patients. During the in-hospital phase, no major adverse cardiac event was observed (reintervention, re-CABG, myocardial infarction or death). Following hospital discharge, one patient had a subacute stent occlusion with chest pain and elevation of cardiac enzymes at 11 days and another patient had a small non-Q wave myocardial infarction with a patent Wallstent (MLD; 2.66 mm) at 22 days. During 6 month follow-up, five patients required balloon angioplasty (four for restenosis and one for stent occlusion). The results of this preliminary study indicate that the new Wallstent may reduce the risk of acute thrombotic occlusion in comparison with its prototype and may convey a favourable outcome in patients with angina after CABG.