Self-expanding stents for emergency treatment of acute vessel closure following coronary angioplasty: immediate and long-term results.
Intracoronary stents may be used to treat acute coronary occlusion following balloon angioplasty.  We report the immediate and long-term results of emergency implantation of the self-expanding stent (Wallstent) in 39 patients with acute vessel closure.  Stents were successfully deployed in 38 patients (97%).  Procedural complications occurred in 14 patients (36%); one patient died, two required emergency coronary artery bypass graft surgery, nine sustained myocardial infarcts (one Q wave), and two had acute stent thrombosis successfully treated by intracoronary thrombolysis and repeat angioplasty.  Four patients (10%) had femoral artery bleeding, two required surgery.  Angiographic follow-up was performed after 6 months in all 34 eligible patients, or earlier for symptoms. Two patients died prior to follow-up angiography.  The stented segment was widely patent in 27 of the 34 patients (79%); restenosis within the stent was detected in 4 (12%) and thrombotic stent occlusion occurred in three (9%).  Twenty-six of the 39 patients (67%) were free from major cardiac events and symptoms at 1 year.  These results suggest that the self-expanding stent provides an attractive alternative to emergency surgery for the treatment of acute coronary occlusion following coronary angioplasty.
Nordrehaug
J E
JE
Department of Invasive Cardiology, Royal Brompton National Heart and Lung Hospital, London, United Kingdom.
Priestly
K A
KA
Chronos
N A
NA
Rickards
A F
AF
Buller
N P
NP
Sigwart
U
U
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D003327:Coronary Disease / Q000628:therapy*; D004630:Emergencies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents / Q000009:adverse effects*; D016896:Treatment Outcome