This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Web of Science (1) Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Tadros, G. M. Articles by Iliadis, E. A. Search for Related Content PubMed PubMed Citation Articles by Tadros, G. M. Articles by Iliadis, E. A. Pubmed/NCBI databases Substance via MeSH Medline Plus Health Information Angioplasty Heart Attack Social Bookmarking                         What's this?

Angiographic and Long-Term Outcomes of "Rescue" Stenting versus PTCA in Failed Thrombolysis in Acute Myocardial Infarction

Department of Internal Medicine, Geisinger Medical Center, Danville, Pennsylvania, gmtadros{at}netscape.net

M. Ashequl Islam, MD, MPH

Department of Cardiology, Geisinger Medical Center, Danville, Pennsylvania

Ayoub Mirza, MD

Department of Internal Medicine, Geisinger Medical Center, Danville, Pennsylvania

James C. Blankenship, MD, FACC

Department of Cardiology, Geisinger Medical Center, Danville, Pennsylvania

Elias A. Iliadis, MD, FACC

Department of Cardiology, Geisinger Medical Center, Danville, Pennsylvania

Percutaneous transluminal coronary angioplasty (PTCA), when performed early after clinically failed thrombolysis, improves acute infarct-artery patency in up to 90% of cases. Limited data are available regarding the role of rescue stenting in this setting. From January 1995 to December 1999, the authors studied all consecutive patients treated with rescue PTCA or rescue stenting within 12 hours of onset of chest pain and clinically failed thrombolytic therapy at their institution. Baseline demographic characteristics, infarct-related artery location, lesion class, left ventricular function, and incidence of multivessel disease were similar between groups (23 patients in each group). Preprocedural TIMI flow 0 was more common in PTCA patients (p=0.025). Quantitative coronary analysis revealed similar incidence of calcification, thrombus burden, minimal lumen diameter (MLD), and lesion length between groups. Post-procedural TIMI 3 flow was more common in stent patients; however, this was not statistically significant (p=0.18). Greater final MLD (p<0.001), less residual stenosis (p<0.001), and a trend toward larger reference vessel diameter (p=0.13) were observed in favor of stent patients. At 6-month follow-up, there was no difference in the incidence of death, myocardial infarction, or readmission for unstable angina between groups. More stent patients (60% vs 27%, p=0.06) were angina free as compared to PTCA patients. Despite similar in-hospital clinical outcomes, the study suggests better angiographic results and 6-month morbidity with rescue stenting.

Angiology, Vol. 55, No. 2, 169-176 (2004)
DOI: 10.1177/000331970405500209


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?