BAILOUT PALMAZ-SCHATZ CORONARY STENTING IN 39 PATIENTS WITH OCCLUSIVE DISSECTION COMPLICATING CONVENTIONAL ANGIOPLASTY

The purpose of this study was to evaluate feasibility, safety, and efficacy of bailout Palmaz-Schatz stenting in a series of 39 patients with coronary dissection associated with acute or unequivocal threatened closure complicating conventional angioplasty, Na anatomical characteristics other than reference vessel diameter <3 mm were considered as contraindications for bailout coronary stenting, Stringent criteria were adopted in defining optimal results (<10% residual stenosis, no angiographic evidence of residual dissection), suboptimal results (>10% residual stenosis or angiographic evidence of residual dissection), deployment failure (failure to deploy the stent because of poor trackability or persistent occlusion despite stent deployment). A total of 49 stents and 7 half-stents were implanted in 36 patients (range 1-5; mean 1.45 +/- 0.84). Successful stenting without in-hospital death, urgent or semielective coronary surgery, stent thrombosis, or Q-wave myocardial infarction was achieved in 33/39 patients (85%). A suboptimal result was associated with an increased risk of in-hospital recurrence of ischemia and other related major adverse events (2/5 patients with suboptimal results vs, 1/31 patients with complete deployment success; P < 0.05), Multiple stents implantation did not carry a significant risk of major cardiac adverse events. The results of this study suggest that bailout Palmaz-Schatz stenting may be considered a stand-alone treatment of coronary dissection if an optimal acute angiographic result is achieved. (C) 1995 Wiley-Liss, Inc.