Interventionell kardiologie: Nach stentimplantation bessere ergebnisse

Within the past few years, coronary stent placement has obtained a central role in interventional cardiology. Since the first human experience in 1986, several large studies demonstrated its advantages. Stent placement is an effective treatment of acute or threatened acute vessel closure after PTCA. Acute clinical and angiographic results are more favorable than after plain PTCA, this is true in particular for some groups with high risk for failure. The initially severe problem of acute thrombotic stent occlusion has become a rare event with the current standard regimen of a combined antiplatelet therapy with aspirin plus ticlopidine, and the possible addition of IIb/IIIa-antagonists. Favorable long-term clinical and angiographic results in comparison to PTCA have been shown by several studies, in particular in patients with a higher risk for restenosis. Despite these advantages, restenosis remains the central problem and is subject of extensive research in progress. This article summarizes our current knowledge of indications and results of coronary stent placement.