[Coronary stenting for treatment of intimal dissection and occlusive thrombosis during primary PTCA in acute myocardial infarction]

Coronary angioplasty during acute coronary syndrome, and particularly in MI, continues to involve a greater risk of acute and subacute occlusion. Stenting for acute or threatened vessel closure has a high initial success rate and reduces the need for emergency bypass surgery. Nevertheless, under these conditions intracoronary thrombus actually appears to be a relative contraindication to stent implantation. We report the successful implantation of two Palmaz Schatz stents to treat a coronary occlusion refractory to multiple ballooning during primary PTCA in myocardial infarction with angiographic evidence of intimal dissection containing thrombus. The good clinical improvement and the results of short- and long-term clinical angiographic follow-up confirm both the feasibility and effectiveness of using this technical approach to manage complications in acute and unstable syndromes.