Bailout Palmaz‐Schatz coronary stenting in 39 patients with occlusive dissection complicating conventional Angioplasty

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Abstract
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. No 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 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.

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