الفهرس | Only 14 pages are availabe for public view |
Abstract Vessel size is a critical anatomical factor inversely related to restonsis rate. Thus percutaneous coronary intervention (PCI) for small vessel are associated with an increased risk of restenosis and adverse outcome (Bigger is Better) (Elezi et al., 1998,(A)). Diabetic patients have increased rates of both restenosis and progression of coronary disease compared to patients without diabetes. Predictors of restenosis in diabetic patients included smaller vessel caliber, greater length of the stented segment, and higher body mass index (West et al., 2004). Various studies have shown that stent design, stent coating and stent strut thickness may determine event-free survival. Cobalt chromium coronary stents are increasingly being used in percutaneous coronary interventions due to its better properties. The aim of this study is to compare cobalt chromium coronary stents with conventional stainless steel stents when both are used for large vessel in diabetic patients. We conducted a study to determine and compare safety & efficacy of chromium stent versus stainless steel stent regarding in–hospital, short & intermediate term prognosis in patient undergoing PCI to lesions < 25mm in large vessels ≥ 3mm in diabetic patients regarding, MACE& ISR. In this study 40 consecutive patients who received intracoronary stents divided in two groups (group one), cobalt chromium stent patients and (group two), stainless steel stent patients in period from January 2008 to December, 2008 in Nasser Institute hospital and Misr university for science&technology Cairo. Baseline characteristics, including patient age, gender, stenosis length, stent location, balloon size, number of stents per patient and presence of ischemic manifestations, were analyzed to determine which of these predicted short -term clinical success. We analyzed cardiovascular risk factors such as hypertension, diabetes, smoking, dyslipidemia and family history of coronary artery disease. Analysis of all angiogram to assess vessel characteristics were performed by an experienced angiographer and site of the stenosis, stenosis length, distal run off and type of the lesion were determinded. In this study we found no significant difference between the two groups regarding their mean age, their sex distribution, history of CAD or risk factors for coronary artery disease (P > 0.05), no significant difference between the two groups regarding the risk factors for coronary artery disease except for dyslipidemia which was found in 11 patients (55% of the C Cr group versus 6 patients (30%) of the SS group P<0.05) No death, or myocardial infarction reported in the two groups. There was no significant difference between the two groups regarding the incidence of in-stent restenosis (P>0.05), and this might be due to some limitations which the study has faced,eg, Small number of patients included in study only (40 patients),short follow up period only three months, Some patients didn’t show up in follow up period, 3 patients (7.5%) and to obtain more precise information regarding I.S.R ,we have had to do follow up coronary angiography for all patients, This was not applicable as some patients didn’t show up in follow up period and others refused to do CA again two patients from CC group and one from SS group,but there was a trend toward lower restenosis rate in Co-Cr stent ( ISR was 5% in Co-Cr stent compared to 15% in SS stent) after three months follow up,although it was not statistically significant. |