PREDICTORS OF MYOCARDIAL-INFARCTION AFTER DISTAL EMBOLIZATION OF CORONARY VESSELS WITH PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY - EXPERIENCE OF 21 CONSECUTIVE PATIENTS WITH DISTAL EMBOLIZATION

Of 1,855 patients with angina pectoris who underwent percutaneous tran sluminal coronary angioplasty (PTCA) in our hospital, 21 experienced d istal embolization. Five of the patients had slow washout of contrast medium distal to the dilated stenosis accompanied by S-T segment eleva tion (slow-flow pattern). In the other 16 cases, a dislodged embolus w as found distal to the dilated stenosis (occlusive pattern) following balloon inflation. Of the 21 patients, 8 (38%) developed acute myocard ial infarction (MI). Ah patients with acute MI were thought to have in traluminal thrombus on angiography performed before PTCA. Interestingl y, patients with recent MI or worsening angina had a significantly hig her rate of acute MI (p < 0.05).