Intracoronary stenting for thrombus-containing lesions in the setting of acute ischemic syndromes.
OBJECTIVE
The presence of intracoronary thrombus was considered a contraindication for stent deployment. Recently, many investigators have demonstrated that the use of stents for thrombus-laden lesions under both elective and bail-out conditions is effective and safe, even in the setting of acute myocardial infarction (AMI).


RESULTS
In this study Palmaz-Schatz stents were implanted to treat suboptimal results and complications of percutaneous transluminal coronary angioplasty (PTCA) in 41 thrombus-containing lesions. Clinical presentation was unstable angina in 24 and AMI in 17 patients. Stents were deployed because of suboptimal result (n = 27), coronary dissection with threatening occlusion (n = 13) or abrupt closure (n = 1). An angiographic successful deployment was obtained in all but one lesions (98%). Four patients (9.8%) suffered from in-hospital complications: three developed a non fatal non-Q wave AMI and one died. There was no need for emergency coronary artery bypass graft surgery, repeat PTCA or blood transfusion for vascular complications. At six-months follow-up one patient (2.6%) developed a non-Q wave AMI and two (5.1%) underwent a repeat coronary angioplasty.


CONCLUSIONS
Our experience confirms that adequately dilated Palmaz-Schatz stent might be safe and effective for thrombus-containing lesions in the setting of acute ischemic syndromes.
Ramondo
A
A
Servizio di Emodinamica e Cardiologia, Interventistica e U.C.I.C., Cattedra di Cardiologia, Università degli Study, Padova.
Bertaglia
E
E
Isabella
G
G
Cardaioli
P
P
Razzolini
R
R
Cacciavillani
L
L
Marzari
A
A
Chioin
R
R
D000368:Aged; D000789:Angina, Unstable / Q000209:etiology; D015906:Angioplasty, Balloon, Coronary; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000601:surgery*; D011859:Radiography; D015607:Stents