INTRACORONARY STENTING IN PRIMARY ANGIOPL ASTY IN ACUTE MYOCARDIAL-INFARCTION

Introduction and objetives. Stent implantation has been generally cont raindicated during primary percutaneous transluminal balloon angioplas ty in AMI, because of its possible trombogenicity. Report the early ou tcome of patients undergoing coronary stenting during primary PTCA. Me thods. From january 1995 to april 1996, 31 patients underwent stent im plantation in primary. Mean age 62 +/- 11 years. Infarct location was anterior in 20 (65%), and inferior in 11 patients (35%). Four patients were in Killip class IV. Mean onset of chest pain was 129 +/- 29 minu tes. Indications for stenting were suboptimal result (64%), dissection (29%) and elective (6%). All patients were treated with heparin durin g 72 hours and antiplatelet therapy with ticlopidine and aspirin. Resu lts. Coronary stenting restored vessel patency with TIMI 3 flow in 29 patients (94%) and TIMI 2 flow in 2 patients. Angiographic control was performed in 80% of the patients: no stent occlusion was observed and all patients showed a TIMI 3 now. There were 3 deaths (9%): 2 patient s died due to cardiogenic shock and 1 to severe right ventricular dysf unction. 2 patients (6%) had recurrent angina, due to other artery. On e patient with left main coronary disease underwent elective coronary artery bypass graft surgery. Conclusions. Intracoronary stent can be u sed successfully during primary angioplasty with a low incidence of co mplications. The long term benefits remains to be stablished.