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Stenting in small coronary arteries (SISCA) trial. A randomized comparison between balloon angioplasty and the heparin-coated beStent
Moer R, et al.
J Am Coll Cardiol 2001;38:1598-603
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11704369

Comparative analysis of stent placement versus balloon angioplasty in small coronary arteries with long narrowings (the Intracoronary Stenting or Angioplasty for Restenosis Reduction in Small Arteries [ISAR-SMART] Trial)
J. Hausleiter, A. Kastrati, J. Mehilli, F. Dotzer, H. Schuhlen, J. Dirschinger, A. Schomig
Am J Cardiol 2002;89:58-60
Full text via ScienceDirect :
http://www.sciencedirect.com/science?_ob=GatewayURL&_origin=CONTENTS&_method=citationSearch&_piikey=S0002914901021646&_version=1&md5=4ae4f187f3d693f9eb70434764d3a126

Stent placement compared with balloon angioplasty for small coronary arteries: in-hospital and 6-month clinical and angiographic results
Koning R, et al.
Circulation 2001;104:1604-8
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11581136 Read Comment

Stent placement to prevent restenosis after angioplasty in small coronary arteries
Doucet S, et al.
Circulation 2001;104:2029-33
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11673341

Comparison of immediate and one-year outcome after coronary angioplasty of narrowing < 3 mm with those > or =3 mm ( the National Heart, Lung, and Blood Institute Dynamic Registry)
Al Suwaidi J, et al.
Am J Cardiol 2001;87:680-6
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=11249883
Treatment of lesions in small coronary arteries in the modern era is associated with high success and low complication rates, comparable to the treatment of large coronary artery lesions, although the incidence of repeat revascularization was significantly greater at follow-up even if stents were used.

Stent Implantation in Small Coronary Vessel - The SUSCI Trial
Antonio Colombo MD Goran Stankovic MD and Leo Finci MD
Click here to view the full article

Coronary stenting versus balloon angioplasty in small coronary artery with complex lesions
Briguori C || Colombo A
Catheter Cardiovasc Interv 2000;50:390-7
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=0010931606
In this retrospective study, 97 lesions in small vessels treated with traditional PTCA were compared with 112 lesions treated by elective stent implantation. MACE, TLR and restenosis at FU (20 +/- 4 months) were not significantly different between the 2 groups (38% in the PTCA group vs 41% in the stent group, P = 0.41)

Review
Provisional Stenting in Small Vessels
Airoldi F || Colombo A
Interventional Cardiology Unit, Columbus Clinic and San Raffaele Hospital, Milan, Italy
Click here to view the full article
The strategy of routine stent placement in small coronary arteries provides good immediate results but is still associated to a high incidence of in-stent restenosis. This manuscript describes the rationale for provisional stenting in this clinical setting and reviews the role of QCA, IVUS and Doppler measurements in the identification of the lesions that would benefit of adjunctive stent placement after balloon angioplasty and in guiding stent implantation.

Randomized comparison of coronary stenting with optimal balloon angioplasty for treatment of lesions in small coronary arteries
Park S || Nah D
Eur Heart J 2000;21:1785-9
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=0011052843
In this study, 120 patients with lesions in small coronary arteries (de novo, non-ostial lesion and reference diameter <3 mm) were randomly assigned to either PTCA or elective stent pacement (7-cell NIR stent). Crossover to stenting in about 20% of patients in the PTCA group because of suboptimal results or major dissection. Angiographic restenosis was 30.9% in the PTCA group vs 35.7% in the stent group (P=NS).

A randomized trial comparing stenting with balloon angioplasty in small vessels in patients with symptomatic coronary artery disease
Kastrati A || Neumann FJ for the ISAR-SMART Study Investigators
Circulation 2000;102:2593-8
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=0011085962
Click here to see the figures
In this study, 204 lesions in small coronary vessels (2-2.8 mm) treated by PTCA were compared with 200 lesions treated by stenting. . The premounted MULTI-LINK stent on 2.5 mm balloons (Guidant, ACS, Inc.) was the recommended stent type in this trial. Angiographic restenosis was 37.4% in the PTCA group vs 35.7% in the stent group (P=NS).

SISA Trial (Stent to prevent restenosis In Small Arteries)
Doucet S || Udaychalerm W
J Am Coll Cardiol. 2000;35(suppl A):8A.
Click here to see the results and comments
Randomized comparison of PTCA vs BeStent implantation in 352 patients with lesions located in small vessels (2.3-2.9 mm). At 6 months, restenosis was 32.4% in the PTCA group vs 28.0% in the stent group (P = NS)

RAP Trial (Restenosis en Arterias Pequeñas)
Presented by Garcia E at TCT 2000
Click here to view the slides
Crossover to stenting in 14% of patients in the PTCA group. In small vessel with focal lesions, the BeStent small reduced MACE and restenosis at 6 month F-up

TCT 2000 Expert Presentation Slides

Update from the SISA Trial
by S. Doucet Click here to see the slides
"R.A.P.
Click here to see the slides

Stenting small coronary arteries using two second-generation slotted tube stents: acute and six-month clinical and angiographic results
Moer R || Golf S
Catheter Cardiovasc Interv 2000;50:307-13
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=0010878627
In this study, 96 patients with 100 lesions in small coronary arteries < 3 mm and with a lesion length < 25 mm were randomly treated by BeStent small or NIR-7 stent implantation after a suboptimal PTCA result. At 6 months (89% angiographic follow-up), restenosis rate was lower in the BeStent small than in the NIR-7 group (16.7 vs 27.7%), but the difference was not statistically significant.

Clinical and angiographic outcome after angiography-guided stent placement in small coronary vessels
Lau KW et al.
Am Heart J 2000;139:830-9
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=0010783217
Optimal angiography-guided coronary stenting of vessels <3.0 mm in diameter in association with the stringent use of a poststent combined aspirin-ticlopidine antiplatelet regimen confers a low risk of stent thrombosis, an acceptable incidence of angiographic instent restenosis, and a favorable long-term clinical outcome

Stent placement for non-STRESS/BENESTENT lesions: A critical review
Wong P et al.
Catheter Cardiovasc Interv 2000;51:223-33
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=0011025583
Stenting lesions with favorable characteristics as required for inclusion in the STRESS/BENESTENT trials have yielded superior results to that of PTCA alone. Results for less favorable lesions such as in small vessels, diffuse disease, ostial disease, and saphenous vein grafts are less well established. This review seeks to analyze available data for stent placement in this subset of non- STRESS/BENESTENT lesions.

Adjunctive intracoronary dipyridamole in the interventional treatment of small coronary arteries: a prospectively randomized trial
Heidland UE || Strauer BE
Am Heart J 2000;139:1039-45
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=0010827385
In this randomized study on 491 PTCA of small coronary arteries with a diameter <2.75 mm, additional intracoronary application of dipyridamole was compared with conventional pretreatment consisting of heparin and aspirin. Intracoronary dipyridamole was associated with a significant reduction of abrupt vessel closure (2.8% vs 8.6%; P =.005) and a nonsignificant reduction of myocardial infarction (1.6% vs 4.5%; P =.07).

Relation of coronary artery size to one-year clinical events after new device angioplasty of native coronary arteries (a New Approach to Coronary Intervention [NACI] Registry Report)
Saucedo JF, et al.
Am J Cardiol 2000;85:166-71.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=10955371

Are small vessels "truly" small?
Dangas G, et al.
J Invasive Cardiol 2000;12:631-2.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11103032

Efficacy of coronary stenting versus balloon angioplasty in small coronary arteries. Stent Restenosis Study (STRESS) Investigators
Savage MP, et al.
J Am Coll Cardiol 1998;31:307-11.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=9462572