INTRACORONARY PALMAZ-SCHATZ STENT PLACEMENT AFTER COMPLICATED ANGIOPLASTY - MEDIUM-TERM FOLLOW-UP

Acute or impending coronary artery occlusion during percutaneous coron ary balloon angioplasty represents a serious and potentially life-thre atening complication. We studied the clinical and angiographic outcome in 21 patients who underwent emergent intracoronary Palmaz-Schatz ste nt implantation (11 due to persistent residual stenosis and 10 due to flow-limiting dissection) during complicated balloon angioplasty and w ho were followed for a mean period of 7.9 +/- 5.7 months. Excluding on e patient lost to follow-up, the event-free survival rate was 70 %. Si x (30 %) patients developed adverse clinical events. One died and 3 re quired elective revascularization procedures. One subacute stent throm bosis was documented. Acute Q-wave myocardial infarction occurred in 2 patients. Among 9 patients studied angiographically 5.6 +/- 2.5 month s after stent placement, 2 had developed restenosis (>50% luminal narr owing). Eleven have remained essentially symptom free. For selected pa tients, emergent deployment of a Palmaz-Schatz coronary stent, followi ng complicated balloon angioplasty, offers satisfactory long-term resu lts, thus obviating the need for a high risk emergency bypass surgery.