Use of an autoperfusion catheter in the treatment of acute refractory vessel closure after coronary balloon angioplasty: immediate and six month follow up results.
OBJECTIVE
To determine the usefulness of the Stack autopersion dilatation catheter in patients with acute recurrent vessel closure during coronary angioplasty.


METHODS
Prospective data collection.


METHODS
University hospital.


METHODS
In 37 of 1003 consecutive patients undergoing angioplasty between November 1989 and December 1990 acute vessel closure developed that could not be redilated by a conventional balloon catheter. 13 (35%) of these 37 patients were sent immediately for emergency bypass surgery.


METHODS
In the remaining 24 patients an attempt was made to reopen the vessel with a Stack catheter.


METHODS
Successful reopening of the vessel. All successfully treated patients were followed for at least six months to detect recurrent ischaemia.


RESULTS
In 16 patients (67%) the Stack procedure was successful. Of the eight patients in whom reopening of the occluded vessel was not achieved, seven were sent for bypass surgery and one was successfully treated by emergency stent implantation. The 16 patients successfully treated with the Stack autoperfusion system were followed up for a mean (SD) of 6.7 (2.6) (range 2 to 11) months. Ten patients remained symptom free but early clinical restenosis developed in four (25%). Overall, only three (19%) of 16 patients experienced recurrence of severe (class III-IV) symptoms and required further mechanical revascularisation.


CONCLUSIONS
These data support the use of the Stack autoperfusion catheter system in selected patients with acute vessel closure not responsive to attempted redilatation with conventional balloon catheters. The short-term outcome seen in this series of patients who were successfully treated with this coronary autoperfusion system is encouraging.
Van Lierde
J M
JM
Department of Cardiology, University Hospital Gasthuisberg, Leuven, Belgium.
Glazier
J J
JJ
Stammen
F J
FJ
Vrolix
M C
MC
Sionis
D
D
De Geest
H
H
Piessens
J H
JH
D000208:Acute Disease; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation* / Q000379:methods; D003327:Coronary Disease / Q000209:etiology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D016896:Treatment Outcome