RESUMO
Although bare metal stents [BMS] resolved abrupt closure which was the most important complication of percutaneous coronary balloon angioplasty, and then drug-eluting stents [DES] significantly reduced the rate of restenosis that was seen in around 30% to 40% at mid-term of post-percutaneous coronary intervention [PCI], but stent thrombosis is still a major problem which occurs in different phases. This study was conducted to evaluate the rate of acute complications, especially acute stent thrombosis [in the first 24 hours] in patients who received either BMS or DES. This retrospective study was performed on 1674 patients [640 women and 1034 men] who underwent PCI with at least one stent [from 2002 until 2006]. 2404 stents were deployed, 975 BMS [40%] and 1429 DES [60%], [820 Cypher, 570 Taxus and 39 other kinds]. 705 stents [35%] were deployed directly and 1699 stents [65%] followed pre-dilatation. In 35 cases [2%], the procedure was not completed because of several reasons [failure of guiding catheter engagement, failure to cross the lesions by guidewires or balloon catheters]. Fourteen patients [0.8%] suffered acute stent thrombosis [eight in the DES and six in the BMS groups], one of whom was referred for emergency coronary bypass surgery [CABG] and twelve patients treated by re-PCI. One patient was complicated by embolic occlusion of a dominant LCX during manipulation of the guiding catheter that was referred to emergency CABG. Two patients suffered left main [LM] dissection, one of whom was treated by prompt stenting and the other after stabilizing by LM stenting, was referred for urgent CABG. Fifteen cases [0.8%] developed slow or no-reflow phenomenon [six cases in the BMS and nine cases in the DES groups] who were managed by medical and mechanical intervention. Twenty five cases [1.5%] had mild CPK-MB rising [ten patients in the BMS and fifteen patients in the DES groups]. Totally 0.3% of cases were referred for emergency or urgent and [1.7%] for elective CABG. Fortunately there was no in-hospital death. This study showed a low and similar incidence of acute complications, especially acute stent thrombosis, in PCI in both BMS and DES groups