The impact of coronary stenting on immediate procedural complication and long-term clinical restenosis at Waikato Hospital.

Aim. Clinical data on coronary senting from within New Zealand is scarce and, in particular, the impact of current stent technologies is unknown. We reviewed all angioplasties undertaken at Waikato Hospital over a two year period to determine the clinical effect of coronary stenting on the local population. Methods. Data from all patients who underwent coronary angioplasty as Waikato Hospital between July 1 1995 and July 1 1997 were included. Stents were deployed either to remedy sub-optimal results, or were electively used for saphenous vein grafts or restonotic lesions. Patient follow-up was obtained through a combination of database reviews, chart search and GP or patient contact. Results. 662 lessions were dalated in 441 patients, 91 lesions were stented, 52.7%, for sub-optimal results following balloon angioplasty. 98% of patients were followed up at six months. Whilst procedural success rate was higher in stented patients compared to unstented patients (96.7% vs 87.5% respectively, p=0.009) the in hospital sub-acute occlysion rate was also increased (6.8% vs 1.9% respectively, p=0.067). At six months, coronary restenosis requiring repeat angioplasty was infrequent (10.9% overall) with no significant difference between the two groups (8.1% vs 11.2% for stented vs unstented patients respectively, p=NS). Conclusions. The use of stents appears effective to improving immediate procedural sucess rates. Despite stented patients being at higher risk initially, their complication and six month clinical restenosis rates were simular.