ABSTRACT
Introduction Since the first year after introduction of balloon angioplasty, percutaneous revascularization of coronary vessels with small luminal reference diameter has been associated with lower rates of procedural success and higher incidence of inhospital events. Many studies indicated that a small lumen size is one of the most important predictors of restenosis after plain old balloon angioplasty.1-3 Shunkert et al4 recently reported a retrospective analysis of their experience between 1994 and 1996 and showed that percutaneous revascularization procedures of coronary vessels with reference diameter <2.5 mm were associated with lower rates of procedural success (92% versus 95%, p 0.006) and higher rates of in-hospital major events (3.4% versus 2.0%; p 0.03) when compared to larger vessels. However, it should be noted that such differences were observed only among patients with non-stented lesions, while the lesions treated with stent implantation (only 18% of the lesions located in small arteries) had no differences in procedural success rate regardless of the vessel reference diameter. Based on these findings, they suggested that the current practice to limit the use of stents to vessels larger than 2.5 mm requires re-evaluation.
