USEFULNESS OF THE WIKTOR STENT FOR TREATMENT OF THREATENED OR ACUTE CLOSURE COMPLICATING CORONARY ANGIOPLASTY

The purpose of this study was to determine the results of the first Wi ktor stent implantations in bailout conditions. From December 1990 to July 1991, in a total of 10 centers, 69 patients presenting with threa tened or total closure after balloon angioplasty each received the Wik tor stent in 1 coronary artery. In these 69 coronary arteries, a total of 72 stent deliveries were attempted and 69 were successful (deliver y success rate 95%). Delivery failure was treated conservatively in 2 patients and surgically in 1 patient. Emergency surgery was also perfo rmed in 2 patients, who after successful stent delivery showed progres sive distal extension of the dissection. In addition, 5 patients under went elective surgery to avoid the possibility of stent thrombosis bec ause the myocardial area at risk was considered too large. Postprocedu ral blood transfusion was performed in 6% of the patients, whereas ste nt thrombosis occurred in 10 of 59 patients (17%), resulting in 2 deat hs. Finally, 65% of the patients had a successful stent implantation w ithout major periprocedural complications. At 6-month follow up, only 9% of the patients experienced recurrent angina, whereas a >50% arteri al diameter narrowing was observed in 27% of the patients. Thus, the r adiopaque Wiktor stent can be accurately and conveniently implanted in dissected coronary arterial segments. However, as for similar bailout devices, the number of thrombotic and bleeding events remains high.