[Intracoronary stent in primary angioplasty in acute myocardial infarction].
OBJECTIVE
Stent implantation has been generally contraindicated during primary percutaneous transluminal balloon angioplasty in AMI, because of its possible trombogenicity. Report the early outcome of patients undergoing coronary stenting during primary PTCA.


METHODS
From january 1995 to april 1996, 31 patients underwent stent implantation 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 minutes. Indications for stenting were suboptimal result (64%), dissection (29%) and elective (6%). All patients were treated with heparin during 72 hours and antiplatelet therapy with ticlopidine and aspirin.


RESULTS
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 flow. There were 3 deaths (9%): 2 patients died due to cardiogenic shock and 1 to severe right ventricular dysfunction. 2 patients (6%) had recurrent angina, due to other artery. One patient with left main coronary disease underwent elective coronary artery bypass graft surgery.


CONCLUSIONS
Intracoronary stent can be used successfully during primary angioplasty with a low incidence of complications. The long term benefits remains to be established.
Pomar Domingo
F
F
Servicio de Cardiología, Hospital General Universitario de Valencia.
Pérez Fernández
E
E
Quesada Dorador
A
A
Atienza Fernández
F
F
Vilar Herrero
J V
JV
Echánove Errazti
I
I
de Velasco Rami
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D003331:Coronary Vessels; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000601:surgery*; D015607:Stents
Stent intracoronario en la angioplastia primaria en el infarto agudo de miocardio.