Effects of systematic cardiac rehabilitation training in elderly patients with unstable angina following cardiac stent implantation

BACKGROUND Coronary stent implantation is usually used to treat unstable angina to alleviate stenosis or occlusion,promoting blood flow restoration and alleviating symptoms such as myocardial ischemia.And postoperative cardiac rehabilitation is essential for enhancing recovery and prognosis.Nevertheless,conventional rehabilitation lacks specificity,particularly for elderly patients with multiple comorbidities and poor compliance,rendering it less effective.AIM To investigate the effects of systematic cardiac rehabilitation training in elderly patients with unstable angina following coronary stenting intervention.METHODS A retrospective enrollment was conducted comprising fifty-four elderly patients with unstable angina pectoris who underwent systematic cardiac rehabilitation training after receiving coronary intervention as the rehabilitation group,while fifty-three elderly patients who received basic nursing and rehabilitation guidance measures after coronary intervention were assigned to the control group.Differences in Seattle Angina Questionnaire scores,survival quality(SF-36)scores,cardiopulmonary exercise function assessment index,echocardiographic cardiac function index,and adverse cardiovascular events were compared between the two groups.RESULTS After intervention,the rehabilitation group observed greater VO2 Max,maximum metabolic equivalent,eft ventricular ejection fraction,left ventricular end-diastolic diameter and smaller left ventricular end-systolic diameter.And the rehabilitation group observed greater scores of physical activity limitation,stable angina pectoris,treatment satisfaction,and SF-36 score.The incidence of adverse cardiovascular events in the two groups,showed no significant difference.CONCLUSION Systematic cardiac rehabilitation following coronary stenting in elderly patients with unstable angina pectoris can enhance cardiac function recovery,consequently enhancing both quality of life and cardiopulmonary exercise tolerance.

Effects of Continuous Precision Nursing Model on Knowledge, Attitudes, and Practices (KAP) Behavior and Cardiac Function in Patients after Percutaneous Coronary Angiography and Stent Implantation

Objective:To explore the impact of a continuous precision nursing model on patients’Knowledge,Attitudes,and Practices(KAP)and cardiac function during the nursing process of patients undergoing percutaneous coronary angiography and stent implantation.Methods:Ninety patients who underwent percutaneous coronary angiography and stent implantation in our hospital from April 2022 to April 2023 were selected and randomly divided into the control group(45 cases),in which routine nursing support was carried out during the treatment process,and the observation group(45 cases),in which continuous precision nursing model was carried out during the treatment process.Comparisons were made between the two groups of patients on their KAP,cardiac function,and quality of life during recovery.Results:There was no difference in the left ventricular ejection fraction(LVEF),cardiac output(CO),and cardiac index(CI)levels before intervention.After the intervention,the levels of cardiac function in the observation group were higher than those of the control group(P<0.05).There was no difference in the Exercise of Self-Care Agency(ESCA)self-care ability scale scores before the intervention.After the intervention,the observation group had higher ESCA scores than the control group(P<0.05).Conclusion:Implementation of a continuous precision nursing model in the care of patients undergoing percutaneous coronary angiography and stent implantation improved the patient’s cardiac function,and KAP,and promoted recovery.

Superficial femoral artery pseudoaneurysm at implantation site of drug eluting stent discovered due to bacteremia:A case report

BACKGROUND Drug-eluting stents(DES)are used to treat lower extremity arterial disease.During DES treatment,aneurysmal degeneration occasionally occurs,especially with fluoropolymer-based DES.However,the incidence of pseudoaneurysms after DES placement is rarely reported in the lower extremity region,although there have been several reports on pseudoaneurysm formation after DES placement in the coronary artery region.CASE SUMMARY We report the case of a 64-year-old man who presented with fever and pain in his left hand after dialysis.Bacteremia was diagnosed by blood culture,and after admission,he developed pain on the medial side of the right thigh.A pseudoaneurysm was observed in the right superficial femoral artery(SFA)at the proximal end of a previously placed DES.The bacteremia was thought to have been caused by a pseudoaneurysm of the left superficial brachial artery,and the pseudoaneurysm of the left superficial brachial artery was removed after antibiotic treatment.The pseudoaneurysm of the right SFA rapidly expanded after admission,but the expansion rate was reduced after infection control.Seven months after the first admission,the pseudoaneurysm of the left SFA was re-moved and in situ revascularization performed using a rifampicin-soaked Dacron graft.CONCLUSION Although pseudoaneurysm after DES placement in the lower extremity region is rare,it must be considered in patients with bacteremia.

Risk factors and outcomes of acute kidney injury after intracoronary stent implantation

Acute kidney injury following percutaneous coronary intervention （PCI） is associated with a worse outcome. However, the risk factors and outcomes of acute kidney injury （AKI） in patients after intracoronary stent implantation are still unknown. A retrospective case control study was done in 325 patients who underwent intracoronary stent implantation from January 2010 to March 2011 at the Drum Tower Hospital of Nanjing University School of Medicine. Those were excluded from the study if they had incomplete clinical data. The patients were divided into a normal group and a AKI group according to the standard of post-operation day 7 to identify AKI. The parameters of the patients included： 1） pre-operative ones： age, gender, hypertension, diabetes mellitus, cerebrovascular disease, left ventricular insufficiency, peripheral angiopathy, creatinine, urea nitrogen, estimated glomerular filtration rate （eGFR）, hyperuricemia, proteinuria, emergency operation, hydration, medications （ACEI/ARBs, statins）; 2） intraoperative ones： dose of contrast media, operative time, hypotension; and 3） postoperative one： hypotension. The parameters were analyzed with univariate analysis and multivariate logistical regression analysis. Of the 325 patients, 51（15.7%） developed AKI. Hospital day and in-hospital mortality were increased significantly in the AKI-group. Univariate analysis showed that age, pre-operative parameters （left ventricular insufficiency, peripheral angiopathy, creatinine, urea nitrogen, estimated glomerular filtration rate, hyperuricemia, proteinuria, hydration）, emergency operation, intraoperative parameters （operative time, hypotension） and postoperative hypotension were significantly different. However, multivariate logistic regression analysis revealed that increased age （OR=0.253, 95%CI=0.088-0.727）, pre-operative proteinuria （OR=5.351, 95%CI=2.128-13.459）, pre-operative left ventricular insufficiency （OR=8.704, 95%CI=3.170-23.898）, eGFR〈60 ml/min/1.73 m2 （OR=6.677, 95%CI=1.167-38.193）, prolonged operative time, intraoperative hypotension （OR=25.245, 95%CI=1.001-1.034） were independent risk factors ofAKl. AKI is a common complication and associated with ominous outcome following intracoronary stent implantation. Increased age, pre-operative proteinuria, pre-operative left ventricular insufficiency, pre-operative low estimated glomerular filtration rate, prolonged operative time, intraoperative hypotension were the significant risk factors ofAKl.

The effects of comprehensive nursing interventions on sexual functions in young and middle-aged patients with coronary stent implantation

Objective: To study the effects of comprehensive nursing interventions on sexual functions in young and middle-aged patients with coronary stent implantation. Methods: 96 cases of coronary stent implantation were randomly divided into control group and intervention group (experimental group) with each group of 48 cases. The control group received the routine nursing measures after the coronary stent implantation and the experimental group was treated by the comprehensive nursing interventions such as psychological nursing, education of sexual knowledge, playing the full enthusiasm of spouse and appropriate exercise therapy on basis of the routine nursing measures. The two groups were given the questionnaire of brief male sexual function questionnaire (BSFI), Chinese patients with premature ejaculation sexual function score (C-ISFPE) and the international index of erectile function (IIEF-5). The scores of BSFI, C-ISFPE and IIEF-5 were compared between the two groups. Results: There were 29 cases who were satisfied with sexual life on the whole (≤1), 26 cases with different degrees of premature ejaculation symptoms and 21 cases with erectile dysfunctions, which were respectively 27.08%, 30.2% and 21.87% of the total number. The scores of BSFI, C-ISFPE and IIEF-5 inthe experimental group were significantly increased after the interventions (P P IIEF-5 scores in the two groups were significantly different

Outcomes of secondary sulcus intraocular lens implantation in unilateral anterior persistent fetal vasculature

AIM: To evaluate the surgical results of sulcus intraocular lens(IOL) implantation in children with unilateral anterior persistent fetal vasculature(PFV) underwent primary vitrectomy combined with lensectomy and preservation of the peripheral anterior capsule.METHODS: Twenty-two eyes of 22 children with unilateral anterior PFV who underwent sulcus secondary IOL implantation were analyzed. Main outcome measures were preoperative and postoperative visual acuity, and complications both intraoperatively and postoperatively. RESULTS: Review of 22 consecutive patients identified best-corrected visual acuity(BCVA) improvement from 1.37±0.84 to 0.73±0.57 logarithm of the minimal angle of resolution(logMAR) after IOL implantation(P<0.001) with a mean follow-up was 16.55±5.86 mo. Average age at secondary IOL implantation was 41.05±15.41 mo. Three eyes(13.64%) achieved BCVA of 0.3 logMAR at the final visit. Transient intraocular pressure rise(4 eyes; 18.18%), postoperative increased inflammation(3 eyes; 13.64%) and postoperative hypotony(2 eyes; 9.09%) were common complications.CONCLUSION: Properly preservation of the anterior lens capsule during the primary surgery facilitated secondary sulcus IOL implantation in pediatric patients with anterior PFV, with favorable postoperative visual outcomes and compatible percentage of complications.

A combination strategy of functionalized polymer coating with Ta ion implantation for multifunctional and biodegradable vascular stents

Biodegradable stents made of magnesium(Mg)and its alloys have been developed to minimize persistent inflammation or in-stent restenosis,which are the main problems for permanent stents.However,their rapid corrosion behavior under physiological conditions leads to poor vascular compatibility and premature structural failure,which remains an important unsolved clinical problem.Herein,we demonstrate a new strategy for solving this problem by combining poly(ether imide)(PEI)coating and subsequent tantalum(Ta)ion implantation.The PEI coating covers the whole surface of the Mg stent uniformly via a spray coating technique and provides Mg with superior corrosion resistance and stable sirolimus-carrying ability.Ta ion implantation is conducted by a sputtering-based plasma immersion ion implantation technique only onto the luminal surface of the PEI-coated Mg stent.Its extremely short processing time(<30 s)permits preservation of the PEI coating’s corrosion protection ability and sirolimus loading characteristics.In addition,a Ta-implanted skin layer that forms on the topmost surface of the PEI coating plays an effective role in not only preventing a rapid release of sirolimus from the surface but also improving the PEI coating’s surface hydrophilicity.Based on in vitro cellular response and blood compatibility tests,Ta ion implantation leads to the improvement of endothelial cell adhesion/proliferation and suppression of platelet adhesion/activation regardless of sirolimus loading.These results indicate that the combination of PEI coating and Ta ion implantation has significant innovative potential to provide excellent vascular compatibility and prevent in-stent restenosis and thrombosis.

Implantation of trabecular micro-bypass stent using a novel “landing strip” technique

AIM：To describe a novel technique of creating a landing strip within the trabecular meshwork to guide trabecular micro-bypass stent（iStent） implantation in patients who underwent phacoemulsification.METHODS：Thirty-four eyes from 30 patients who underwent i Stent implantation after phacoemulsification from May 2014 to February 2015 were included in our retrospective study. All iStents were implanted via the ＂landing strip＂ technique. A 25-gauge microvitreoretinal blade was used to bisect the trabecular meshwork to less than 1 clock-hour, effectively creating a landing strip. The iStent applicator was pressed along the landing strip and then the stent was released into the trabecular meshwork. RESULTS：Of the 34 eyes with iStent implantation, 27（79.4%） eyes had primary open-angle glaucoma, 6（17.6%） eyes had pseudoexfoliation glaucoma, and 1（2.9%） eye had ocular hypertension. At 6-month follow-up（n=17）, the mean number of hypotensive medications decreased from 2.2±1.2 at baseline to 0.8±1.3（P=0.05） and mean intraocular pressure decreased from 19.7±4.1 mm Hg at baseline to 16.7±2.1 mm Hg（P=0.58）. Two eyes（5.9%） required subsequent trabeculectomy. CONCLUSION：The ＂landing strip＂ technique appears to be an effective way to assist with iS tent implantation.

Hepatic artery stenosis angioplasty and implantation of Wingspan neurovascular stent: A case report and discussion of stenting in tortuous vessels

BACKGROUND Hepatic artery stenosis is a complication of orthotopic liver transplant occurring in 3.1%-7.4%of patients that can result in graft failure and need for retransplantation.Endovascular therapy with angioplasty and stenting has been used with a high degree of technical success and good clinical outcomes,but tortuous hepatic arteries present a unique challenge for intervention.Suitable stents for this application should be maneuverable and conformable while also exerting adequate radial force to maintain a patent lumen.CASE SUMMARY Herein we report our experience with a neurovascular Wingspan stent system in a challenging case of recurrent hepatic artery stenosis and discuss the literature of stenting in tortuous transplant hepatic arteries.CONCLUSION Wingspan neurovascular stent is self-expanding,has good conformability,and adequate radial resistance and as such it could be added to the armamentarium of interventionalists in the setting of a tortuous and stenotic transplant hepatic artery.

Double-vessel verylate stent thrombosis following Resolute Onyx zotarolimus eluting stents implantation in an octogenarian

Compared with bare-metal stents (BMS),drug-eluting stems (DES)have shown better clinical outcomes for pa- tients undergoing percutaneous coronary intervention (PCI) by inhibition of neo-intirnal hyperplasia.[1]However,early- generation DES produced late thrombotic events,more than l-year,by delaying arterial healing of stented vessels,[2-5] New-generation DES have been developed'with thinner stent struts,more biocompatible polymer coatings for drug release,and a variety of antiproliferative agents with similar or superior anti-restenotic efficacy.[6]This development has led to a significant improvement in the efficacy and safety of new-generation DES,and consistently lower rates of very late stent thrombosis (VLST).[7,8]In fact,use of new-ge- neration DES is the standard treatment in contemporary PCI practice.[9]

Prolonged dual antiplatelet therapy after drug-eluting stent implantation improves long-term prognosis for acute coronary syndrome:five-year results from a large cohort study

BACKGROUND:To investigate the most appropriate dual antiplatelet therapy(DAPT)duration for patients with acute coronary syndrome(ACS)after drug-eluting stent(DES)implantation in the largest cardiovascular center of China.METHODS:We enrolled 5,187 consecutive patients with ACS who received DES from January to December 2013.Patients were divided into four groups based on DAPT duration:standard DAPT group(11-13 months,n=1,568)and prolonged DAPT groups(13-18 months[n=308],18-24 months[n=2,125],and>24 months[n=1,186]).Baseline characteristics and 5-year clinical outcomes were recorded.RESULTS:Baseline characteristics were similar across the four groups.Among the four groups,those with prolonged DAPT(18-24 months)had the lowest incidence of major adverse cardiovascular and cerebrovascular events(MACCEs)(14.1%vs.11.7%vs.9.6%vs.24.2%,P<0.001),all-cause death(4.8%vs.3.9%vs.2.1%vs.2.6%,P<0.001),cardiac death(3.1%vs.2.6%vs.1.4%vs.1.9%,P=0.004),and myocardial infarction(MI)(3.8%vs.4.2%vs.2.5%vs.5.8%,P<0.001).The incidence of bleeding was not different among the four groups(9.9%vs.9.4%vs.11.0%vs.9.4%,P=0.449).Cox multivariable analysis showed that prolonged DAPT(18-24 months)was an independent protective factor for MACCEs(hazard ratio[HR]0.802,95%confidence interval[CI]0.729-0.882,P<0.001),all-cause death(HR 0.660,95%CI 0.547-0.795,P<0.001),cardiac death(HR 0.663,95%CI 0.526-0.835,P<0.001),MI(HR 0.796,95%CI 0.662-0.957,P=0.015),and target vessel revascularization(HR 0.867,95%CI 0.755-0.996,P=0.044).Subgroup analysis for high bleeding risk showed that prolonged DAPT remained an independent protective factor for all-cause death and MACCEs.CONCLUSION:For patients with ACS after DES,appropriately prolonging the DAPT duration may be associated with a reduced risk of adverse ischemic events without increasing the bleeding risk.

The Cost-effectiveness Analysis of Percutaneous Transhepatic Metal Versus Plastic Biliary Stent Implantation for Treating Malignant Biliary Obstruction (Multiple Center Investigation)

Objective: To compare metal versus plastic biliary stent implantation for treatment of malignant biliary obstruction in cost-effectiveness ratio (CER). Methods: Percutaneous transhepatic self-expandable metal stent (MS, n=61) or 10F plastic stent (PS, n=34) implantation was performed in 95 patients with malignant biliary obstruction in three hospitals of Guangdong province. All patients were followed up until death or at least one year after the procedure. Kaplan-Meier analysis was used to compare the survival and stent patency rates of the patients in the two groups. CERs of two groups were calculated. The main indexes were CERsurvival period (total cost/median survival period), CERpatency period (total cost/median patency period). Results: The total costs of treatment were 53177±3139 yuan (RMB) in MS group and 42564±4950 yuan (RMB) in PS group respectively (P>0.05). CER in MS group was superior to that in PS group (CERsurvival period was 237.4 yuan /d vs 452.6 yuan /d, respectively; CERpatency period was 231.2 yuan /d vs 472.9 yuan /d, respectively). Conclusion: The metal stent implantation is superior to the plastic stent in the CER for treatment of malignant biliary obstruction.

Metal stent implantation for palliation of malignant biliary obstruction-a report of 57 cases

AIMS To report the first experience in China in the treatment of malignant biliary obstruction with expand- able metal stent which allows the insertion of an endo- prosthesis as large as one cm in diameter. METHODS Between April 1994 and May 1996,we implanted expandable metal stents in 57 patients with incurable malignant biliary obstruction,among whom 54 underwent endoscopic procedure and the other 3 re- ceived percutaneous transhepatic placement. RESULTS Insertion of the stent following guidewire positioning was successful in 95% of the patients. Two patients developed cholangitis after stent insertion and were successfully treated with conservative treatment. The jaundice was eliminated completely in 21 cases and markedly decreased in 23 cases within 2 weeks af- ter placement of the stent. Nine patients,however, had late cholangitis due to stent failure after a median interval of 14 days. Twenty-three cases underwent na- sobiliary transient drainage and 3 underwent plastic stent transient drainage prior to metal stent insertion. Transient drainage was believed to have the advan- tages of drainage pre-assessment and infection controlling. CONCLUSIONS Our results show that expandable metal stent is suitable for the irresectable malignant choledochal stenosis. It can eliminate the jaundice and improve the patient's life quality. To get the highest benefit,however,the indication should be strictly selected. And to get long-term patency,the proximal and distal end of the stent proceeding the tumor should be no shorter than 2cm. In the case of hilar cancer, Bismuth classification is greatly helpful for the choice of drainage site.

Intravascular ultrasound assessment of the incidence and predictors of edge dissections and intramural hematomas after drug-eluting stent implantation

Objective We used intravascular ultrasound (IVUS) to assess incidence, predictors, morphology, and angiographic findings of edge dissections and intramural hematomas after drug-eluting stent (DES) implantation. Methods We studied 887 patients with 1 045 non-in-stent restenosis lesions in 977 native arteries undergoing DES implantation with IVUS imaging, and compared the dissected stent end to the non-dissected stent end. Results Eighty-two dissections were detected; 51.2% (42/82) involved the proximal and 48.8% (40/82) the distal stent edge. When compared to the non-dissected stent end, residual plaque area [(8.0±4.3) mm2 vs (5.2±3.0) mm2, P【0.01], plaque burden [(52±12)% vs (36±15)%, P【0.01], plaque eccentricity (8.4±5.5 vs 4.0±3.4, P【0.01), and stent edge symmetry (1.17±0.11 vs 1.14±0.08, P=0.02) were larger; plaque burden≥50% was more frequent (62% vs 17%, P【0.01) and calcium deposits (52.5% vs 35.6%, P=0.03) more common; and the lumen/stent area (0.86±0.16 vs 1.02±0.18, P【0.01) was smaller in the stent dissected end. Independent predictors of stent edge dissection were residual plaque eccentricity (OR=1.3, P【0.01) and residual plaque burden≥50% (OR=7.3, P【0.01). Intramural hematomas occurred in 34.1% (28/82) of dissections.Independent predictors of intramural hematomas were plaque eccentricity (OR=1.4, P=0.005), plaque burden≥50% (OR=7.1, P=0.02), and mean lumen diameter to stent diameter ratio (OR=0.37, P=0.04).Concluslon IVUS identified edge dissections after 9.4% of DES implantations. Residual plaque eccentricity and significant plaque burden predicted coronary stent edge dissections. Dissections in less diseased reference segments with an arc of normal vessel wall (greater plaque eccentricity) more often evolved into an intramural hematoma.

Two case of preoperative bridging therapy for patients undergoing non- cardiac surgery after coronary stent implantation

It has been reported that up to 12% of patients underwent non-cardiac surgery or invasive procedures within the first year after the coronary stent implantation. Premature dis- continuation of antiplatelet therapy is associated with a sig- nificant increase in mortality and major adverse cardiac events, in particular, stent thrombosis. Thus, postpone- ment of elective surgery is advocated during the first year after the coronary stent implantation.

A CLINICAL ANALYSIS OF 24 PATIENTS WITH ACUTE MYOCARDIAL INFARCTION TREATED WITH PTCA AND INTRACORONARY STENT IMPLANTATION

The data of 24 cases(18men,6women) with AMI treated with directPTCA and intracoronary stant implantation were analyzed.The infart-related vessels were 13 LADs,4LCXs,7KCAs:The successful rate washigh(95.8%).The mean stenoses before and after performation were 95.6±5.4%,8.3±0.2%.18 stems were implanted in 16 cases.Lesscomplication happened during the procedure.There was a higher TIMI Ⅲflow patency rate in PTCA and intracoronary stent implantation than indrug thrombolysis (92% vs 40%).Stent implantation had a significanteffect on myocardial reperfution by enhancing the successful rate ofPTCA and reducing the stenosis significantly.

Persistent left superior vena cava and pacemaker implantation

Our study group read with interest the paper from Vijayvergiya et al describing the implantation of an implantable cardioverter-defibrillator lead in the presence of the persistence of the left superior vena cava.The issue of the identification a persistent left superior vena cava is of paramount importance in interventional cardiology,being the most common venous anomaly of the thoracic distribution,and because it may create some problem to any physician while performing a pacemaker lead implantation.In our letter we underscore the specific issues related to pacemaker implantation while encountering a persistent left superior vena cava(and maybe the absence of the right vena cava)and the workup that should be performed to obtain the preoperative diagnosis of the venous anomaly.More specifically,we consider avoiding any kind of defibrillator lead implantation through the coronary sinus for safety issues,and underscore the straightforward transthoracic ultrasound approach to identify the left superior vena cava.

Clinicsl research of Palmaz-Schatz stent implantation

Objective To evaluate the clinical efficacy of Palmaz-Sctatz(P-S)stent,and sum up the experience of P-S stent implantation.Methods The P-S stent were implanted in 79 patients with 85 coronarylesions.According abscences of in hospital death.emergency coronary arterybypass grafting(CABG),Q wave myocardial infarctina(MI)or repeatintervention,measured the primary successfui rate of stent implantation atpostoperatively and the bail out rate of acute coronary closure afterpercutaneous transluminal coronary angioplasty(PTCA).Clinical follow upin 74 of 82 lesions of successful stent implantation was obteined at 3-6month after operation,the restnotic rate was measured by quantitativecoronary angiography.The restenosis was defined as】50% diameterstenosis at follow up.Results In 79 patients with 85 coronary lesion.82 were successfulimplanted.the successful rate was 96%.The Q wave MI 2 patients andemergency CABG 1 patient in 3 patients of unsuccessful stent implantation,and that have not death and repeat interveation.The 28 patients weredelivered in 31 patients with acute coronary closure after PTCA.The bailout rate was 90%.12 have restenosis in 82 lesions of follow up at 3-6month after stent implantation,the restenotic rate was 16%.Conclusion The successful rate of P-S stent implantation was high.andthe occur rete of major adverse events was lower than other stents.Thebail out rate was high in acute coronnry closure after PTCA.The restenotierate at 3-6 month after stunt implantation has lower than other stents.Butthe P-S stent yes not suitable for medium winding blood vessel and was

Angiographic Iongterm follow-up after coronary stent implantation in acute myocardial infarction

Stent implantation in acute myocardial infarction(AMI)has been shown to improvethe acute angiographic outcomes.So far few data on long-term angiographic follow-up are avallble.Methods:We studied 130 consecutive patients(mean age 58±11,24 women)betweenOctober 1993 and October 1997,in whom coronary stonts were implanted afterunsuccessful percutaneous transluminal coronary angioplasty (PTCA)in AMI.Quantitative coronary angiography(QCA)was performed and residual stenosis wasmesuremesured for all patients immediately and for 74 patients at a mean of 6 months afterthat procedure.Results:The infarct related artery was the left anterior dascending in 60(46%)pts,the circumflex in 15(12%)and the right coronary artery in 55(42%).At baseline,72(55%)pts had a totally occluded artery(TLMI0)and 11(8%)TIMI 1 flow. Eight(6%) pte were given aboiximab(ReoPro) or thrombolyais to deal with acute slantthrombosis during the intervention.Immedately after stent implantation,angiographicsuccess(TLMI 3)was obtained in 113(87%)pts,TLMI2 in 14 (11%)and TLMI 1 intwo (2%). Only three pts had residual stonosis(≥50% stenosis)immediately aftertreatment.Except the patients who had coronary artery bypass grafting(CABG)ordied coronary angiographic follow-up was performed in 74(70%)pts at a mean of 6months following the intervention(Table).Conclusion:Rescue stent implantation after failed PTCA in AMI may improve initialangiographic results,but we found a higher restenosis-rate and reintervention-rate inthe long-term run as compared with selectiv stent implantation.

ROUTINE HIGH PRESSURE BALLOON INFLATIONS AFTER CORONARY STENT IMPLANTATION WITHOUT ANTICOAGULATION

Wikter-i and multilink Coronary stent has beenimplanted in 38 lesions in 31 patients.Theindications for stent implantation were 21 elective,11 chronic total occlusion.4 threatened closure and2 suboptimal.Vessel distribution was 21 LAD,8 RCA,9LCX,Successful stent implabation was achievied inall of pstients,Lession length was 15.3±8.6mm.Theaverage final balloon size after stent placement was4.5mm(range 3.5-6.0mm) end minimal luminal diameterwithin the stent was 3.75mm(range 3.0-4.0mm).Maximum inflation pressure was 14±2 atmospheres.AWiktor-i stent used in 21 lesions and multilinkstent in 17 lesion.All of patients were treated withonly antiplatelet therapy after successful stentimplantation,There was no stent thrombosis orvascular complication.Mean elapsed time from stentplacement to femoral sheath rsmoval was 5.6 hours(range 4-7hours).Patients were discharged from thehospital within 1 week of stent placement,allreceiving aspirin 300mg per day,end ticlopidine250ms twice a day,In three months of clinic follow-up,no patients experienced stent throebosJs.After astent is deployed,routine high pressure ballooninflation is performed within the stent to ensureuniform circumferential expansion and optimalopposition of the stent to the vessel wall.Whenoptimal stent expansion was achieved,there was nostent thrombosis despite the absence of anti-coagulation in all of patients.