[Use of intracoronary stents without anticoagulants. Experience of the Hospital Espanõl of Mexico]

Abstract

Our initial experience with intracoronary stenting without oral anticoagulant is presented. From december 1994 to december 1995 we implanted 58 stents in 43 patients (36 males). Indications were: retraction 1, restenosis 3, dissection 8, acute myocardial infarction 13 and de novo 33. All patients received ticlopidin, aspirin and diltiazem before the procedure, heparin and intracoronary nitroglycerin were given during the procedure, and ticlopidin and aspirin for the next six weeks. Non-compliant balloons at 14-16 atmospheres were used for stent implantation. The balloon/artery ratio was 1:1. Implant sites were: 29 in left anterior descendent, 17 in right coronary artery, 7 in circumflex and 5 in vein grafts. This procedure was successful in 40/43 (93%) patients. One patient died and 2 had acute occlusion. One patient underwent coronary artery bypass grafting and the other underwent a new dilatation with higher pressure. There were no subacute occlusions. During 140 days mean time follow up: 2 patients had angina (incomplete revascularization) and 27 patients with negative stress test. No myocardial infractions or deaths were present during the follow up period. Stent implantation with high pressure technique and without oral anticoagulant in coronary arteries greater than 3.0 mm is a safe and effective method with high rate success and very low acute complication rate.