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Coronary stenting for failed angioplasty in acute myocardial infarction
M el Setiha1, M el Gamal, J Koolen
1Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands.
Insights
Intracoronary stenting after failed angioplasty in acute myocardial infarction (AMI) shows favorable long-term outcomes. Most patients remained free from major ischemic events after a mean follow-up of 18.7 months.
Area of Science:
- Interventional Cardiology
- Cardiovascular Research
Background:
- Percutaneous transluminal coronary angioplasty (PTCA) can be unsuccessful in acute myocardial infarction (AMI).
- Intracoronary stenting is an alternative treatment option in such cases.
Purpose of the Study:
- To evaluate the long-term efficacy and safety of intracoronary stenting in patients with AMI following failed PTCA.
Main Methods:
- 15 patients with AMI underwent intracoronary stent implantation after failed PTCA.
- Stents were implanted in the left anterior descending (LAD) artery (11 patients), right coronary artery (RCA) (3 patients), and a venous bypass graft (1 patient).
- A total of 16 stents were used (15 Palmaz Schatz, 1 Wiktor).
Main Results:
- One patient died 10 days post-procedure due to renal failure and cardiogenic shock.
- Subacute stent thrombosis occurred in 2 patients, both successfully treated with emergency coronary artery bypass grafting (CABG).
- The remaining 12 patients experienced no major ischemic events (death, AMI, revascularization) during a mean follow-up of 18.7 months.
Conclusions:
- Intracoronary stenting is a favorable long-term treatment option for acute myocardial infarction patients with failed PTCA.
- The procedure demonstrates acceptable safety and efficacy despite early complications in a subset of patients.
Unlabelled:
Intracoronary stents were implanted in 15 patients after unsuccessful PTCA in the setting of acute myocardial infarction (AMI). The stented vessel was the left anterior descending (LAD) in 11 patients, the right coronary artery (RCA) in 3 patients, and a venous bypass graft to the LAD in a single patient. A total of 16 stents were implanted (15 Palmaz Schatz, Johnson and Johnson; and 1 Wiktor, Medtronic).
Follow-Up:
1 patient died 10 days after stent implantation as a result of renal failure and cardiogenic shock. Subacute thrombosis occurred in 2 patients, 5 and 15 days after stent implantation; both underwent successful emergency coronary artery bypass grafting (CABG). The remaining 12 patients were free from major ischemic events (death, AMI, and further revascularization) after a mean follow-up of 18.7 +/- 4.1 months. We conclude that the long-term results of intracoronary stenting in AMI after failed PTCA are favourable.