TEMPORARY STENT AS A BAIL-OUT DEVICE DURING PERCUTANEOUS TRANSLUMINALCORONARY ANGIOPLASTY - PRELIMINARY CLINICAL-EXPERIENCE

Objective-To evaluate the safety and efficacy of a prototype temporary stent (RX Flow Support Catheter, Advanced Cardiovascular Systems) in maintaining coronary perfusion and improving vessel patency in the eve nt of acutely compromised flow complicating percutaneous transluminal coronary angioplasty. Design-Prospective clinical study as part of a m ulticentre trial. Setting-Regional cardiac centre catheterisation labo ratory. Patients-Eight patients undergoing routine percutaneous transl uminal balloon coronary angioplasty in whom coronary artery dissection resulted in impaired coronary artery flow with angina or electrocardi ographic ST segment shift, needing bail-out treatment at the time of t he procedure. Results-The RX Flow Support Catheter was successfully us ed and improved coronary flow in all cases, with a reduction in lumina l stenosis and resolution of symptoms. The temporary stent was expande d for an average of 85 (range 30-209) minutes. In six patients it was used as a bridge to further treatment (permanent stent in four and cor onary artery surgery in two) and two patients did not need further tre atment. Conclusion-The temporary stent was safe and effective in the a cute management of coronary dissection. The main advantages are its ea se and speed of use, and successful restoration of coronary flow both to the distal artery and to affected side branches pending definitive treatment.