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Anti-platelet Treatment After Intravascular Ultrasound Guided Optimal Stent Expansion - APLAUSE
Description:
Aspirin and ticlopidine in patients undergoing IVUS-guided stent implantation.
Hypothesis:
To evaluate the safety and efficacy of reduced anticoagulation with aspirin and ticlopidine in patients undergoing IVUS guided elective stent implantation of native or saphenous vein graft lesions.
Study Design
Study Design:
Patients Screened: Not given
Patients Enrolled: 222
Mean Follow Up: 12 months
Patient Populations:
Patients with native or saphenous vein graft lesions
Elective Palmaz-Schatz stenting
No angiographic evidence of thrombus
Lesion requiring < 3 stents
Primary Endpoints:
Major adverse coronary events at 30 days
Drug/Procedures Used:
Palmaz-Schatz stents with high-pressure (≥ 16 atm) adjunct PTCA.
Concomitant Medications:
Aspirin and ticlopidine
Principal Findings:
Procedural success rates were 99% and stent thrombosis was rate (< 1%) for patients undergoing "optimal" Palmaz-Schatz stent implantation.
A total of 222 patients (186 native lesions and 112 saphenous vein grafts) were followed for 12 months after the initial procedure. There were no deaths or infarctions in the native vessel group. The mortality rate was 2.3% in the vein graft subgroup.
Target lesion revascularization rates were 11.8% in the native vessel subgroup (7% PTCA; 4.8% CABG) and 18.7% in the vein graft group (13.4% PTCA; 5.4% CABG).
Interpretation:
Optimal stent placement results in favorable long-term clinical benefit in both native and vein graft lesions, with rare deaths, no infarctions, and < 20% target lesion revascularization at 1 year.
References:
1. Circulation 1996; 94(Suppl I): I-686 Preliminary results
Keywords: Coronary Artery Disease, Infarction, Platelet Aggregation Inhibitors, Thrombosis, Saphenous Vein, Ticlopidine, Stents
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