Improving results of bailout coronary stenting after failed balloon angioplasty.
Stent implantation can be a valuable alternative to emergent bypass surgery to treat established or threatening abrupt closure following coronary balloon angioplasty. To evaluate several sequentially introduced changes in our practice of bail-out stenting, we compared the first (group I) and second half (group II) of our single center experience (n = 88). Use of bailout stenting increased over time (2% of all angioplasty procedures in group I vs. 6% in group II, P < 0.001), more often to prevent rather than to reverse abrupt closure. Technical success of stent implantation was unchanged (95% vs. 93%), and there was a decreasing trend for stent thrombosis (14% vs. 5%), in-hospital death (5% vs. 2%), Q-wave myocardial infarction (9% vs. 7%), and requirement for surgery (9% vs. 7%). The incidence of non-Q-wave myocardial infarction (29% vs. 7% P < 0.01), bleeding complications (27% vs. 7% P < 0.01), and hospital stay duration (11 +/- 11 vs. 8 +/- 5 days P < 0.05) decreased. Our data suggest that coronary stent implantation is currently an effective stand-alone bailout procedure for a large majority of failed angioplasty procedures.
Metz
D
D
Cardiology Center, University Hospital, Geneva, Switzerland.
Urban
P
P
Camenzind
E
E
Chatelain
P
P
Hoang
V
V
Meier
B
B
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003327:Coronary Disease / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents / Q000009:adverse effects; D013927:Thrombosis / Q000517:prevention & control*