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To the Editor: The Abciximab in Ischemic Stroke Investigators reported the encouraging results of their randomized, double-blind, placebo-controlled, dose-escalation trial.1 Of 74 eligible and consenting patients presenting within 24 hours of onset of their ischemic stroke, 54 patients were treated with 4 escalating doses of intravenous abciximab and 20 patients with placebo. The scheduled post-study CT brain scan detected asymptomatic parenchymal hemorrhages in 7% of abciximab-treated patients and 5% of placebo-treated patients; another 11% of abciximab-treated patients had asymptomatic parenchymal hemorrhages on unscheduled brain imaging (CT or MRI) performed on days 2 through 35. Symptomatic hemorrhagic transformation was not seen, while asymptomatic parenchymal hemorrhages were associated with a higher baseline National Institute of Health Stroke Scale (NIHSS) score. We would raise the following issue for clarification by the authors and report our limited experience of using abciximab in Chinese stroke patients. Concomitant use of antithrombotic medications during the time period of diagnosing parenchymal hemorrhage was listed in Table 3 of the article.1 The scheduled CT brain scan detected asymptomatic parenchymal hemorrhages in patients A, D, G, H, and I, who also received concomitant antithrombotic medications, such as systemic heparin, low-dose heparin, aspirin, and warfarin sodium. Nevertheless, the study protocol required that antiplatelet agents or anticoagulants not be administered until the results of the scheduled CT brain scan became available (as …

The balloon-expandable, stainless steel, flexible coil stent is a useful device for managing acute or threatened closure after percutaneous transluminal coronary angioplasty.1–5 Use of the device is associated with thrombosis of the stented vessel in a small but important group of patients.3,6–10 The clinical, angiographic, and procedural factors associated with stent thrombosis with this device are still unknown. The objective of this study was to define predictors of stent thrombosis occurring within the ftrst month after stenting with this device.

The balloon expandable, stainless steel, flexible coil stent is a useful device for the management of acute or threatened closure after percutaneous transluminal coronary angioplasty. Appropriate sizing is important to optimize immediate results and reduce the risk of acute thrombosis and restenosis. The in vivo size at deployment of this stent at nominal inflation pressures has not been evaluated. Forty patients who received a single flexible coil stent (10 patients each for stent sizes 4.0, 3.5, 3.0, and 2.5 mm) were studied. The stents were deployed at 3-5 atmospheres. The actual stent size achieved by the stent during deployment was found to be significantly less than the nominal size, being 3.7 +/- 0.3, 3.2 +/- 0.2, and 2.8 +/- 0.2 mm for nominal stent sizes of 4.0, 3.5, and 3.0 mm, respectively (P < 0.005, P < 0.001, and P < 0.01). For a 2.5 mm stent, it was 2.4 +/- 0.2 mm (P = ns). Thus, for optimal results with this device, we recommend that vessels 2.0-2.4 mm in diameter be supported by a 2.5 mm stent, vessels 2.5-2.9 mm in diameter by a 3.0 mm stent, vessels 3.0-3.4 mm in diameter by a 3.5 mm stent, and vessels 3.5-4.0 mm in diameter by a 4.0 mm stent.