Implante de prótesis endovasculares (stents) en el tratamiento de la cardiopatía coronaria: resultados angiográficos, clínicos inmediatos y tardíos / Endovascular stent placing in the treatment of coronary artery disease: angiographic, immediate and late clinical results

RESUMO

Background: Coronary revascularization allows a better survival and quality of life in high risk patients with coronary artery disease. Aim: To report the experience in stent placement as treatment for obstructive atherosclerotic coronary artery disease. Patients and methods: A prospective analysis of 105 stent placements. A morphological and quantitative analysis of coronary angiograms, using an electronic caliper, was performed. Patients were followed during their hospital stay and after discharge. Results: In four of 112 coronary lesions, it was not possible to liberate the stent and in 108, it was successfully placed (48 in anterior descending, 19 in circumflex, 36 in right coronary arteries and 5 in saphenous aortocoronary by-pass. Lesions with stent implantation were type A in 11 percent, B1 in 30 percent, B2 in 44 percent and C in 15 percent. Reference diameter was 3.13 ñ 0.58 mm. After placement, luminal diameter increased from 0 95 ñ 0.43 to 2.99 ñ 0.46 mm, with a final stenosis of 7.2 ñ 10.1 percent. Angiographic success was obtained in 99 percent and procedure success in 98 percent. Hospital mortality was 0.98 percent. After a mean of eight months follow up, 91 percent of patients is free of major cardiac events. In 17 percent angina recurred and 5 percent required a new revascularization. There were no late cardiac deaths, acute stent thrombosis or infarction in relation to the treated lesion. Conclusions: In these patients, stent placement has had excellent immediate and late results: