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A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
04:30

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis

Published on: May 14, 2013

Effectiveness of primary percutaneous coronary interventions for stent thrombosis

Guido Parodi1, Gentian Memisha, Benedetta Bellandi

  • 1Division of Cardiology, Careggi Hospital, Florence, Italy. parodiguido@gmail.com

The American Journal of Cardiology
|March 31, 2009
PubMed

Insights

Primary percutaneous coronary intervention (PCI) for stent thrombosis (ST) is uncommon. While PCI successfully restores vessel patency in ST-elevation myocardial infarction (STEMI) patients, high rates of restenosis and reocclusion lead to poor outcomes.

Area of Science:

  • Cardiology
  • Interventional Cardiology

Background:

  • Data on the effectiveness of primary percutaneous coronary interventions (PCIs) for stent thrombosis (ST) treatment are limited and conflicting.
  • Stent thrombosis (ST) is a rare but serious complication following percutaneous coronary intervention (PCI).

Purpose of the Study:

  • To evaluate the prevalence, efficacy, and outcomes of primary PCI in patients experiencing ST-elevation acute myocardial infarction (STEMI) due to ST.
  • To compare outcomes of primary PCI for ST-related STEMI versus de novo STEMI.

Main Methods:

  • Retrospective analysis of 2,464 consecutive patients treated with primary PCI for STEMI.
  • Identified 67 patients (3%) with STEMI caused by ST.
  • Compared clinical characteristics, procedural data, and short- and long-term outcomes between ST and de novo STEMI groups.

Main Results:

  • Patients with ST had lower rates of collateral circulation and higher peak creatine kinase levels.
  • Primary PCI was successful in 96% of ST patients, often involving additional stenting or thrombectomy.
  • Procedure and fluoroscopy times were longer, and more contrast medium was used in the ST group.
  • Six-month rates of death and nonfatal reinfarction were higher in the ST group.
  • Six-month restenosis/reocclusion rates were significantly higher in the ST group (54%) compared to the de novo STEMI group (17%).

Conclusions:

  • Primary PCI for ST is infrequently utilized.
  • While PCI can restore patency in ST, high rates of restenosis and reocclusion are observed.
  • ST treated with successful PCI is associated with larger infarct size and poorer clinical outcomes.

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