[Acute and intermediate clinical and angiography results after coronary stent implantation]

Abstract

The value of stenting in emergency situations in interventional angioplasty procedures is widely accepted. Stenting remains controversial as a therapeutic method for use beyond the acute phase, as the results reported in the acute phase are characterized by a wide range. This study reports the implantation results of Palmaz-Schatz stents in 64 cases mostly for failed PTCA. Stents were mounted on Monorail-PVC-balloon catheters. The acute success rate was 96.8%. In two cases with stent misplacement CABG was performed within 48 h. No lethal events occurred in the acute phase. Stent thrombosis has only been seen in four cases (6.5%) so far under subtle monitoring of the anticoagulant regime. Restenosis rate (definition: NHLBI-4) according to serial angiography 6 and 12 weeks after implantation was 4.25% at 6 weeks, with a cumulative rate of 19.4% up to 12 weeks. All recurrences eligible for PTCA have been successfully redilated. A high extracardiac complication rate--predominantly groin hematoma--is the main disadvantage of the procedure. Surgical repair was necessary in 11.4% up to 6 weeks after implantation. Surprisingly high was also the incidence of hematuria, also in 11.4%, in the phase of high anticoagulation. In conclusion, stenting is an effective therapeutic method to avoid emergency CABG and elective CABG in most cases of failed PTCA.