[Coronary stent in acute myocardial infarction].

Autor:	Villavicencio Fernández R; Departamento de Hemodinámica, Instituto Nacional de Cardiología Ignacio Chávez INCICH, México, D.F., Marchena Noriega A, Eid Lidt G, Martín del Campo AL, Peña Duque MA, Gaspar Hernández J, Ban Hayashi E, Ariza González H, Martínez Ríos MA
Jazyk:	Spanish; Castilian
Zdroj:	Archivos del Instituto de Cardiologia de Mexico [Arch Inst Cardiol Mex] 1998 Jan-Feb; Vol. 68 (1), pp. 18-26.
Abstrakt:	Unlabelled: From December 1995 to March 1997 fifty patients with acute myocardial infarction, had 57 stents implanted. Mean time since the beginning of symptoms to the procedure was 3.7 +/- 2.9 hours. Twenty-four stents were implanted "de novo", 17 for "sub-optimal" results, 5 for threatened closure and eleven for complex dissection. The arteries treated with stent were left anterior descending in 42%, right coronary in 42%, circumflex in 10%, vein grafts in 4%, intermedial branch in 1% and marginal obtuse branch in 1%. Stent used in most of the cases was AVE in 67% followed by Palmaz-Schatz, Wiktor, Crown, Gianturco-Roubin and Wallstent. Before procedure, coronary flow was TIMI 0 in 66% TIMI 1 in 10% and TIMI 2 in 24%. After procedure, TIMI 3 coronary flow was achieved in 92% of the arteries and other four had "no-reflow" phenomenon. Mean stenosis before procedure was 96% +/- 3.1 and after stenting was 1.76% +/- 2.6 with a stent/artery diameter rate of 1.01. Technical success was 100% and clinical success was achieved in 96% of the cases. Two cases were not successfully due to acute thrombotic closure in one patient and in another one because of cardiogenic shock after two days of a technical successful implantation of stent in LAD artery. There were not recurrent ischemic events (CABG, re-infarction or new coronary angioplasty procedure). Other two patients died for non-cardiac events (acute pancreatitis in one and by septic shock in other). At the time of discharge 96% of patients were treated with aspirin and ticlopidine. Major hematoma was evident in only one case. At a mean follow-up time of 5.6 months +/- 4.2 in 45 patients showed that 73% were in functional class I and none of them had re-infarction, death or needed a new revascularization. Conclusion: Stent implantation in acute myocardial infarction is feasible and safe procedure with a low rate of ischemic recurrent events.
Databáze:	MEDLINE
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