Contribution of stenting to the results of rescue PTCA

Failed thrombolysis in acute myocardial infarction (AMI) is associated with increased mortality. Controversial benefit of rescue percutaneous translum inal coronary angioplasty (PTCA) in these setting has been published, The f easibility, safety, and contribution of stenting to the outcome of AMI pati ents treated with this strategy is unknown. We studied the angiographic res ult and clinical outcome of 33 patients with failed thrombolysis referred f or rescue angioplasty. Twenty-three patients had stenting and 10 patients d id not have stenting. Both groups had similar clinical and angiographic cha racteristics. Stent indications were nonoptimal result, 40%; bailout, 40%; elective, 20%, Angiographic success was 100% with stent vs, 91% with balloo n alone (P < 0.8). Postprocedure residual stenosis was 1.5% (0%-10%) with s tent vs, 18.05% (0%-30%) with balloon alone (P < 0.01). Thirty-day outcome with and without stent was mortality, 0% vs. 13% (P < 1.0); reinfarction, 1 0% vs. 0% (P < 0.30); target vessel revascularization, 0% vs. 21% (P < 0.21 ). The 6-month mortality was 0% with stent vs. 14% (P < 0.5). We conclude t hat stenting during rescue angioplasty is feasible, safe, and is associated with better immediate angiographic results. Although no obvious clinical b enefit was found, a potential decrease in the revascularization rate was su ggested. Cathet, Cardiovasc. Intervent 47:411-414, 1999, (C) 1999 Wiley-Lis s, Inc.