Balloon Angioplasty and Stent-Supported Angioplasty for Acute Myocardial Infarction

Background：Although the superior reperfusion and improved clinical outcome following angioplasty for acute myocardial infarction (AMI) have been well known, 10 to 15% of reinfarction and recurrent ischemia in hospital are main limitation of primary percutaneous transluminal coronary angioplasty (PTCA).This study was undertaken to examine the safety and feasibility of stent-supported primary angioplasty in acute myocardial infarction.Methods：Between July 1995 and Jun.1997, 32 patients underwent direct or rescue PTCA, including patients with cardiogenicc shock.After PTCA, stentingwas attempted in patient with dissection or having more than 30% of residual stenosis.Result：In patient with direct PTCA, angiographic success rate was obtained in 91%(30/32).Stenting was attempted in 15 of 30 patients.These patients had suboptimal results (8 patients), nonocclusive dissection (3 patients) and acute occlusion (2 patient).Thrombolysis in myocardial infarction (TIMI) grade 3 flow was restored in 28 patients (93%).In one patient no-reflow phenomena was observed following stent insertion.Despite intra-aortic balloon pumping, there was one death during the hopitalization due to cardiogenic shock following PTCA.Subacute stent thrombosis developed in two patients.27 patients (90%) were event-free and clinically improved through out the follow up period (11.5±5.2 month).Quantitative angiography showed excellent angiographic result after stenting compared with balloon PTCA (2.4±0.6 mm vs. 3.4±0.3mm p<0.01).Conclusion：After failure of initial angioplasty, coronary stenting can be a supportive therapeutic strategy.Coronary stenting results in a high degree of angiographic success, a low incidence of subacute thrombosis.( ( ( (Korean Circulation J 1998 ; 28( ( ( (7) ) ) ) : 1185-1191) ) ) ) KEY WORDS：Acute myocardial infarction•Stent-supported angioplasty. 서 론급성