Intracoronary stenting in 18 cases of acute myocardial infarction
- Author:
Yingfeng LIU
1
;
Xiangyang FU
;
Xuexian QIAN
;
Lei LIU
;
Zhijian WU
;
Dongfeng LU
;
Xia ZHAO
Author Information
1. 第一军医大学附属珠江医院
- From:
Chinese Medical Journal
1998;111(4):0-0
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the initial experience of intracoronary stenting in patients with acute myocardial infarction (AMI) in our hospital.Methods Ballon-expansion stents were deployed in 18 patients (male: 15, female 3, aged between 38-72 years old) with AMI after emergency PTCA. The major indications for intracoronary stenting in our present study include: 1) acute reocclusion or high risk of reocclusion due to intimal dissection; 2) severe residual stenosis (≥50% diameter stenosis) after repeat balloon dilation; and 3) obvious elastic recoil failed to response to repeat intracoronary nitroglycerin infusion. The dilating pressure for stent implantation was 12-18 atm with a dilating time of 10-30 sec. Patients were heparized during catheter maneuvers and were medicated with Ticlopidine (250 mg, twice daily) for 3 months and aspirin (250 mg, once daily) after stenting.Results 1) Coronary angiography (CAG) showed that all patients (n=18) had a single-vessel total occlusion (left anterior decending 9, right coronary artery 8, and left circuflex 1) before emergency PTCA and was successfully restored to TIMI 3 grade blood flow after intracoronary stenting (13 with Nir stent, 1 with Jonson and Jonson stent, and 4 with Cordis stent). 2) Minor residual intracoronary thrombosis was presented in 5 of 18 patients after PTCA, and it was totally disppeared after stenting; 3) One patient with inferior infarction developed Ⅲ degree atrioventricular blockade (AVB) and temporary pacemaker was introduced. This patient died of cardiac tamponade 6 h after stenting due to right ventricular perforation by electrode. No cardiac death, recurrent angina and reinfarction occurred during the 4-16 months follow-up peroid in the other 17 patients; 4) No angiographically restenois was found in all the 3 patients who had a secondary conronary angiography 4 weeks after stenting. 5) Left ventricular ejection fraction (LVEF) determined with Doppler echocardiography 4 weeks after stenting tended to be improved but failed to reach significant difference as compared to the basal LVEF (43.27%±8.43% vs 40.58%±7.23%, P>0.05, n=17) measured within 24 h after the onset of chest pain.Conclusions These results suggest that intracoronary stenting is a highly effective strategy in prevention or treatment of acute reocclusion after emergency PTCA in AMI. Minor residual intracoronary thrombosis after balloon dilation was not a contraindication for stent implantation.
