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1999, Número 4

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Rev Mex Cardiol 1999; 10 (4)


Resultados iniciales con aplicaciones de Stents en adultos jóvenes y evolución a mediano plazo

Palomo VJA, Farell CJ, Abundes VA, Ledesma VM

Idioma: Español
Referencias bibliográficas: 46
Paginas: 135-142
Archivo PDF: 190.45 Kb.


RESUMEN

Revisamos nuestra experiencia y evaluamos los resultados clínicos y angiográficos así como el seguimiento a mediano plazo de los pacientes adultos jóvenes ‹ 40 años que fueron sometidos a angioplastia coronaria transluminal percutánea (ACTP) con colocación de prótesis endovasculares (stents). Durante el periodo comprendido entre febrero de 1994 a julio de 1999, en el cual se realizaron 856 procedimientos de ACTP con colocación de stents. Se incluyeron sólo a un grupo selecto de 22 pacientes (con 24 procedimientos con un promedio de 1.09 stents por paciente) con edades de 21 a 39 años, promedio de 31.8 ± 6.2, de sexo masculino 21 (95.4%) y sólo una mujer (4.5%), siete enfermos (31.8%) con angina severa según la Asociación Canadiense de Cardiología (ACC). Con antecedente de infarto del miocardio previo 15 (68.1%). El porcentaje promedio de obstrucción arterial 90.08 ± 5.22 y la fracción de expulsión con rangos de 35 a 60% promedio 46.8 ± 4.3. El éxito angiográfico inmediato fue de 91%, sólo en dos 9%, pacientes con oclusión del 100% y mayor a tres meses se fracasó. No existió mortalidad, así como tampoco se envió a ningún enfermo a cirugía. El seguimiento fue de dos a 50 meses, en todos con prueba de esfuerzo (PE) eléctrica tipo Bruce y/o de medicina nuclear, sólo tuvimos en dos enfermos con PE y talio con isquemia septal leve. Se obtuvo control angiográfico en el 50%. Conclusiones: la ACTP con stent es un procedimiento exitoso angiográfico y clínico en adultos jóvenes ‹ 40 años, constituye una terapéutica de revascularización completa y eficaz y por lo tanto una excelente opción alternativa antes de ser enviados a cirugía.


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