ONE-WEEK AND 6-MONTH ANGIOGRAPHIC CONTROLS OF STENT IMPLANTATION AFTER OCCLUSIVE AND NONOCCLUSIVE DISSECTION DURING PRIMARY BALLOON ANGIOPLASTY FOR ACUTE MYOCARDIAL-INFARCTION

We prospectively assessed in 124 consecutive patients by means of I-we ek and 6-month follow-up angiograms the rate of reocclusion and resten osis of coronary stenting with Palmaz-Schatz stents after occlusive an d nonocclusive dissection during primary balloon angioplasty for acute myocardial infarction (AMI), Patients were further evaluated clinical ly at 1 year, Stenting was performed on large (>3,2 mm) coronary arter ies for suboptimal results (47%), occlusive (8%), or nonocclusive diss ections (45%) after balloon angioplasty. Stents were delivered using t he bare stent technique and high pressure inflations (>12 atm), All pa tients received ticlopidine 250 mg (500 mg if weight was >80 kg) and a spirin 100 mg for 1 month, No patient received warfarin, At 1 week, 6 patients died of cardiogenic shock and 2 of right ventricular infarcti on, One subacute occlusion occurred at day 14, At 6 months, in 95 pati ents, the angiographic restenosis rate (>50% diameter stenosis) was 19 %. One-year clinical follow-up, available in 55 patients, indicated ca rdiac death in 5, and repeat revascularization in 3, Thus, coronary st enting on large (>3,2 mm) coronary arteries after occlusive and nonocc lusive dissection during primary balloon angioplasty for AMI using bar e Palmaz-Schatz stents, high pressures, ticlopidine, and aspirin is sa fe, Our reocclusion and restenosis rates are similar to those of trial s on elective stenting in stable patients. (C) 1997 by Excerpta Medica , Inc.