Preliminary Result of Intracoronary Stenting in Thrombus Containing Lesion

ABSTRACT

BACKGROUND: Intracoronary stent implantation is a promising modality for establishing the blood flow of complex coronary arterial stenosis. However, previous studies have demonstrated that the angiographically visible thrombus is a high risk factor for possibility of stent thrombosis. So many investigators avoided stent implantation traditionally for thrombus containing lesion because of the potency of thrombogenecity of stent. But recently, advanced rapidly growing technique for stenting and powerful antithrombotic regimens make stent thrombosis rare. Stent implantantion has already been showed a acceptable method for bailout procedure of thrombotic occlusion in patients with angioplasty for acute myocardial infarction and also effective in intimal dissection, suboptimal results and arterial recoil. Accordingly, we investigated the effectiveness of stent implantation in the presence of intracoronary thrombus. METHODS: Eighteen patients(AMI 14, Unstable angina 4) underwent PTCA & stent implantation on culprit arterial lesion in all successfully. The stent group was comprised of Palmatz-Schatz stent 10, Cordis 2, Cook 5 and Jo-Med stent 1. Stent implanted to the lesion of remained thrombus visualization on coronary angiography after PTCA. RESULTS: No major complications were developed during hospitalization in all 18 patients. In all patients no stent thrombosis have occurred within 2 weeks after stent implantation. But one patients have showed intracoronary stent thrombus persistently, so we used intracoronary urokinase infusion for 36 hours but there was no visible thrombus after modified anticoagulation and antithrombotic regimen CONCLUSIONS: We harvested good preliminary results of intracoronary stent implantation in the setting of thrombus containing lesion.