Self‐Expanding Stents for Emergency Treatment of Acute Vessel Closure Following Coronary Angioplasty: Immediate and Long‐Term Results

Intracoronary stents may be used to treat acute coronary occlusion following balloon angioplasty. We report the immediate and long-term results of emergency implantation of the self-expanding stent (Wallstent) in 39 patients with acute vessel closure. Stents were successfully deployed in 38 patients (97%). Procedural complications occurred in 14 patients (36%); one patient died, two required emergency coronary artery bypass graft surgery, nine sustained myocardial infarcts (one Q wave), and two had acute stent thrombosis successfully treated by intracoronary thrombolysis and repeat angioplasty. Four patients (10%) had femoral artery bleeding, two required surgery. Angiographic follow-up was performed after 6 months in all 34 eligible patients, or earlier for symptoms. Two patients died prior to follow-up angiography. The stented segment was widely patent in 27 of the 34 patients (79%); restenosis within the stent was detected in 4 (12%) and thrombotic stent occlusion occurred in three (9%). Twenty-six of the 39 patients (67%) were free from major cardiac events and symptoms at 1 year. These results suggest that the self-expanding stent provides an attractive alternative to emergency surgery for the treatment of acute coronary occlusion following coronary angioplasty.