Angiographic follow-up and clinical experience with the flexible Tantalum Cordis stent.

Abstract

The Cordis stent is a flexible, highly radioopaque intracoronary stent engineered from a single Tantalum filament folded into a sinusoidal helical coil. It is premounted on a semicompliant balloon expandable stent delivery system. From September 1995-March 1996, 147 Cordis stents were deployed in 105 patients (aged 58+/-12 yr, 71% male). Clinical indications for stenting were unstable angina in 59 (55%), stable angina in 41 (38%), and acute myocardial infarction in 7 (7%). The target vessel was the right coronary artery in 45%, the left anterior descending in 31%, and the circumflex artery in 22%. One stent was deployed in a vein graft, and one stent was deployed in a left internal mammary artery graft. Stent deployment was achieved in all but one patient. Acute in-stent thrombosis occurred in 3 patients (2.9%). Two of these patients required urgent coronary artery bypass surgery. Subacute stent thrombosis occurred in 2 patients (1.9%). Minimum lumen diameter increased from 0.70+/-0.41 mm to 3.50+/-0.60 mm following stent placement. All patients received aspirin. Eighty-one patients (77%) received ticlopidine, and 4 patients (4%) received warfarin therapy. The mean hospital stay was 3.4+/-2.3 days. Six-month follow-up angiography was performed on 50 out of 55 eligible patients at one of the two institutions involved in this study. Computer-assisted quantitative coronary angiography defined a restenosis rate of 26%. Repeat revascularization was required in 8 patients (14.5%) at 6-mo follow-up. The Tantalum Cordis intracoronary stent is an effective and safe means of treating coronary lesions, even in patients with unstable ischemic syndromes. Acute and subacute rates of in-stent thrombosis were acceptable, and the long-term angiographic restenosis rates and need for repeat revascularization were favorable.