מתוך medicontext.co.il
NEW YORK (Reuters Health) – Direct stenting, rather than stenting after primary angioplasty, may benefit some patients with acute myocardial infarction, French researchers report in the January 2nd issue of the Journal of the American College of Cardiology.
Dr. Christophe Loubeyre and colleagues from the Hפpital Claude Galien, Quincy-sous-Sיnart, randomly assigned 206 AMI patients to direct stenting or to stent implantation after balloon dilation. Direct stenting failed in eight patients, but stent implantation was successful in all patients after balloon dilation.
Direct stenting significantly reduced the combined angiographic end point of slow and no-reflow or distal embolization compared with conventional stenting (12 versus 28 patients respectively, p = 0.01). Also, among patients receiving direct stenting, 17 did not have ST-segment resolution compared with 32 of the patients who underwent conventional stenting (p = 0.01), Dr. Loubeyre's team found.
They report that two patients died and/or had a recurrent MI after direct stenting compared with six patients who underwent conventional stenting.
"Percutaneous coronary intervention for AMI benefits from the direct use of stents without pre-dilation," Dr. Loubeyre and colleagues conclude. "Such an approach is safe, feasible and reduces the incidence of no-reflow or distal embolization; moreover, it may favorably influence the outcome of primary angioplasty."
They add that "a significant effect on early ST-segment elevation resolution after percutaneous transluminal coronary angioplasty suggests that direct stenting prevents microvascular damage and may improve myocardial reperfusion."
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