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The aim of the present study was to assess the procedural safety and in-hospital and long-term effectiveness of heparin-coated Jostents after failed thrombolysis in acute myocardial infarction. We prospectively analyzed the acute and long-term clinical and angiographic outcomes of 35 consecutive patients treated with heparin-coated Jostents for thrombolytic failure. Rescue coronary stenting was successful in 34 of 35 patients (97%). Thrombolysis in Myocardial Infarction flow grade 3 was obtained in 31 patients (88.5%). The only patient with procedural failure died from cardiogenic shock a day after the procedure. One patient (2.8%) underwent an emergency coronary bypass operation because of angiographic evidence of stent thrombosis with re-infarction. During in-hospital follow-up, 2 patients (5.7%) underwent an elective coronary bypass operation after successful stent implantation of the infarct-related artery because of existing severe multivessel coronary artery disease. Minor bleeding complications at the vascular access site occurred in 3 (8.6%) patients. No cerebrovascular or any other major bleeding complication occurred. One patient (2.1%) underwent repeat coronary angioplasty for restenosis and an elective coronary artery bypass operation was performed in one patient (2.8%) during the 294 +/- 150 days follow-up. The rate of target vessel revascularization was 14.3% and the event-free survival rate was 80%. Twenty-six patients (90%) had angiographic follow-up at six months, and stent restenosis was found in 5 (19.2%). This study demonstrates that heparin-coated Jostents are sale, with low in-hospital and long-term mortality rates for the treatment of failed thrombolysis in acute myocardial infarction. The angiographic restenosis and target vessel revascularization rates of this registry are also acceptable.

Rescue Coronary Stenting with Heparin-coated Jostents for Failed Thrombolysis in Acute Myocardial Infarction