Giornale italiano di cardiologia · 1997
[Endocoronary stent: its use to improve suboptimal outcome of angioplasty].
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Marzocchi A, Piovaccari G, Marrozzini C, Ortolani P, Palmerini T, Bacchi M L, Nobile G, Marinucci L, Branzi A, Magnani B
Аннотация
BACKGROUND: This single-center report describes the results of unplanned coronary stenting for the treatment of suboptimal angiographic results after conventional coronary angioplasty (PTCA), Suboptimal results of PTCA were defined as: a) residual stenosis > or = 30% with TIMI flow 3; b) presence of coronary dissection < 15 mm with TIMI flow 3.
PATIENTS: From January 1994 to December 1995, 213 patients with suboptimal result of PTCA underwent coronary stent implantation.
RESULTS: Stenting resulted in a technical and angiographic success in 99.5% of patients. In-hospital complications involved acute myocardial infarction (2.3%), coronary artery bypass grafting (1.4%), re-PTCA (2.3%) and vascular complications at the puncture site (1.4%). No deaths occurred. The in-hospital complication rate was similar in the groups of patients stented for coronary dissection or residual stenosis > or = 30%. Instead, the combined antiplatelet treatment group showed lower rates of subacute stent thrombosis (0.8 vs 8.9%; p = 0.011) and major complications (1.6 vs 10%; p = 0.016) than the ASA-warfarin treatment group. At a six-month follow-up, clinical restenosis was detected in 9.5% of patients. Re-PTCA was performed in 7.1% of patients and elective coronary bypass grafting in 2.8%. No acute myocardial infarction occurred and one patient presented a non-cardiovascular death. At the end of the follow-up, only 5.2% of the patient were still symptomatic.
CONCLUSIONS: The unplanned use of intracoronary stenting for the treatment of suboptimal result of PTCA improves the immediate angiographic result, reducing the procedural complication rate with good short- and long-term clinical results.
PATIENTS: From January 1994 to December 1995, 213 patients with suboptimal result of PTCA underwent coronary stent implantation.
RESULTS: Stenting resulted in a technical and angiographic success in 99.5% of patients. In-hospital complications involved acute myocardial infarction (2.3%), coronary artery bypass grafting (1.4%), re-PTCA (2.3%) and vascular complications at the puncture site (1.4%). No deaths occurred. The in-hospital complication rate was similar in the groups of patients stented for coronary dissection or residual stenosis > or = 30%. Instead, the combined antiplatelet treatment group showed lower rates of subacute stent thrombosis (0.8 vs 8.9%; p = 0.011) and major complications (1.6 vs 10%; p = 0.016) than the ASA-warfarin treatment group. At a six-month follow-up, clinical restenosis was detected in 9.5% of patients. Re-PTCA was performed in 7.1% of patients and elective coronary bypass grafting in 2.8%. No acute myocardial infarction occurred and one patient presented a non-cardiovascular death. At the end of the follow-up, only 5.2% of the patient were still symptomatic.
CONCLUSIONS: The unplanned use of intracoronary stenting for the treatment of suboptimal result of PTCA improves the immediate angiographic result, reducing the procedural complication rate with good short- and long-term clinical results.