RESUMO
Objective To investigate the safety and effectiveness of sirolimus-eluting stents (SESs, Cypher stents) in the treatment of acute myocardial infarction. Methods Ninety seven SESs were implanted in 78 lesions of 78 patients with acute myocardial infarction. In all the lesions, 20.7% of the target vessel diameter ≤2.5 mm, 26% was in-stent restenosis, 82.3% was total occlusions lesions and 17.7% with degree of stenosis up to 95%. The in-hospital procedural success rate and the incidence of complications were observed. Major adverse cardiac events, restenosis rate and late lumen loss were also observed during follow-up. Results All stents were implanted successfully. There were no remained stenosis and major in-hospital complications. During clinical follow-up of 6-15 months (mean 10?3.6 months), 2 patients had recurrent angina due to in-stent restenosis confirmed by angiography, and required target vessel revascularization. No major adverse cardiac events was found in the other 76 patients, and the mortality was null. Follow up quantitative coronary angiographies were obtained in 64 patients, 9?2.2 months after the procedure. The average late lumen loss were 0.24?0.05 mm at the proximal edge, 0.19?0.03 mm within the stent segment, and 0.10?0.02 mm at the distal edge. The angiographic in-lesion restenosis rate was 3.1% and target vessel revascularization was 2.6%. Conclusion SES may be safe and feasiable for the treatment of acute myocardial infarction through reduction in restenosis and target vessel revascularization at 9 months after intervention.
RESUMO
Objective To compare the safety and efficacy of sirolimus-eluting stents (SES) and Pixel stents (PS) for treatment of coronary small vessel disease. Methods From March 2003 to January 2005, 67 patients with coronary small vessel disease were randomly divided into two groups: group A (n=34) and group B (n=33). Group A was treated with SES and group B with PS. The procedural success rate, major adverse cardiac events, restenosis rate and late lumen loss were compared between two groups. Results Procedural success rate in both groups was 100% without remained stenosis and cardiac complications. There were 30 patients in group A and 29 in group B whose quantitative coronary angiography was obtained 9 months after the procedure. Two patients in group A had recurrent angina because of in-stent restenosis, and 6 out of 7 patients with the angina in group B had angiographic evidence of in-stent restenosis. No death occurred in both groups during clinical follow-up. Angiographic restenosis rate was 6.7% in group A and 20.7% in group B (P