Abstract
Nineteen consecutive procedures of coronary stenting were attempted in 70 consecutive patients (27%) with evolving myocardial infarction due to threatened vessel reocclusion after primary (16 cases) or rescue (3 cases) angioplasty. Two patients were in cardiogenic shock. Stent delivery was successful in 18 patients, with a Thrombolysis in Myocardial infarction flow grade 3; residual diameter stenosis and minimum luminal diameter were 19% +/- 11% and 2.96 +/- 0.62 mm, respectively. After the procedure, heparin was continued for 4 days and 250 mg ticlopidine twice a day for 1 month. Acute stent occlusion occurred in one patient 1 hour after the procedure and was successfully treated with emergency repeat angioplasty. Subacute stent occlusion occurred 6 days after the procedure in one patient, with multivessel coronary disease and a suboptimal stent result. He had been referred for surgery, and emergent coronary artery bypass was performed. Coronary bypass surgery was performed in another patient before discharge because of severe multivessel disease. Persistent cardiogenic shock and new myocardial infarction in another location were the causes of death in two patients, 3 and 10 days after the procedure, respectively. Fifteen pati...Continue Reading
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