Customize your JAMA Network experience by selecting one or more topics from the list below.
Al Suwaidi J, Berger PB, Holmes, Jr DR. Coronary Artery Stents. JAMA. 2000;284(14):1828–1836. doi:10.1001/jama.284.14.1828
Author Affiliations: Division of Cardiovascular Diseases and Department of Internal Medicine, Mayo Clinic and Foundation, Rochester, Minn.
Clinical Cardiology Section Editors: Bruce
Brundage, MD, University of California, Los Angeles, School of Medicine; Phil
B. Fontanarosa, MD, Executive Deputy Editor, JAMA.
Context Intracoronary stents are now used for the majority of patients undergoing
percutaneous coronary revascularization, and the body of scientific knowledge
about stents has expanded rapidly in the last several years.
Objective To review the evidence supporting the widespread use of intracoronary
Data Sources The MEDLINE database was searched for articles from 1990 through January
2000 using the indexing terms stents, coronary artery disease, and angioplasty.
Additional data sources included bibliographies of articles identified on
MEDLINE, bibliographies in textbooks on percutaneous coronary interventions,
and preliminary data presented at recent national and international cardiology
Study Selection We selected for review studies that assessed the effects of stenting
on the immediate and long-term outcome of patients undergoing percutaneous
coronary revascularization. If data from randomized controlled trials were
not available for specific patient subsets or lesion characteristics, observational
studies were included.
Data Extraction The methodologic characteristics of studies in coronary stenting were
extracted and summarized according to key components of research design, including
lesion type, location, and adjunctive therapy used. Studies were classified
according to the strength of the available data into proven and unproven indications
for stent use.
Data Synthesis Coronary artery stents increase the safety of interventional procedures,
increase procedure success rates, and decrease the need for emergency coronary
artery bypass graft surgery.
Conclusions Intracoronary stents have become an essential component of the catheter-based
treatment of coronary artery disease. The evidence indicates that elective
stenting, rather than provisional stenting or balloon angioplasty alone, improves
clinical outcomes in the months following percutaneous coronary revascularization
in a wide variety of clinical settings and lesion types.
Create a personal account or sign in to: