[Coronary stent in acute myocardial infarction]. / Stent coronario en el infarto agudo del miocardio.

UNLABELLED: From December 1995 to March 1997 fifty patients with acute myocardial infarction, had 57 stents implanted. Mean time since the beginning of symptoms to the procedure was 3.7 +/- 2.9 hours. Twenty-four stents were implanted "de novo", 17 for "sub-optimal" results, 5 for threatened closure and eleven for complex dissection. The arteries treated with stent were left anterior descending in 42%, right coronary in 42%, circumflex in 10%, vein grafts in 4%, intermedial branch in 1% and marginal obtuse branch in 1%. Stent used in most of the cases was AVE in 67% followed by Palmaz-Schatz, Wiktor, Crown, Gianturco-Roubin and Wallstent. Before procedure, coronary flow was TIMI 0 in 66% TIMI 1 in 10% and TIMI 2 in 24%. After procedure, TIMI 3 coronary flow was achieved in 92% of the arteries and other four had "no-reflow" phenomenon. Mean stenosis before procedure was 96% +/- 3.1 and after stenting was 1.76% +/- 2.6 with a stent/artery diameter rate of 1.01. Technical success was 100% and clinical success was achieved in 96% of the cases. Two cases were not successfully due to acute thrombotic closure in one patient and in another one because of cardiogenic shock after two days of a technical successful implantation of stent in LAD artery. There were not recurrent ischemic events (CABG, re-infarction or new coronary angioplasty procedure). Other two patients died for non-cardiac events (acute pancreatitis in one and by septic shock in other). At the time of discharge 96% of patients were treated with aspirin and ticlopidine. Major hematoma was evident in only one case. At a mean follow-up time of 5.6 months +/- 4.2 in 45 patients showed that 73% were in functional class I and none of them had re-infarction, death or needed a new revascularization. CONCLUSION: Stent implantation in acute myocardial infarction is feasible and safe procedure with a low rate of ischemic recurrent events.

[Coronary stents. Results during the hospitalization phase]. / Stent coronario. Resultados en fase hospitalaria.

UNLABELLED: Between October 1991 and August 1996 two-hundred coronary stents were implanted (s) in 166 patients (pts) (1.27 s/pt). One hundred thirty-five lesions "de novo" were approached with stent, 44 because of a sub-optimal result post-angioplasty, 15 for restenosis and 17 for dissection. In thirty-six patients the indication of stenting was stable angina, in 68 unstable angina, in 37 for angina after myocardial infarction, in 11 for asymptomatic ischemia after myocardial infarction and in 14 during an acute myocardial infarction. Mean stenosis before stent implantation in all cases was 85 +/- 15%. Type of lesion in seventy cases was A, in 112 was B and 29 was C. Stents used were AVE in 146 lesions, Palmaz-Schatz in 33, Wiktor in 23, Gianturco-Roubin in 8 and Wallstent in one case. Medical treatment in 140 pts. (84.3%) after stent implantation was only with aspirin and ticlopidine. Technical success in all patients was 98.6% (208/211 pts) and primary success was 94.6% (157-166 pts). Unsuccessful procedures were because of sub-acute occlusion in three patients (1.8%), death in 3 pts. (1.8%) and urgent CABG was necessary in one pt. (0.5%). Major hematoma was a complication in 5 pts (3%). Mean residual stenosis after stent implantation in all cases was 2.2%. CONCLUSION: Stent implantation in our laboratory is a very safe procedure with a high rate of primary success with lowest complications in a great population of unstable angina.