Muhammed Necati Murat Aksoy, İbrahim Kocayiğit, Yusuf Can

Perkütan Koroner Girişim Sırasında Gelişen Stent Kaybının Sıklığı, Demografik Özelliklerinin ve Tedavilerinin Değerlendirilmesi: Tek Merkez Deneyimi

Amaç Bu çalışmanın amacı perkutan koroner girişim sırasında stent kaybı gelişen hastaların demografik özelliklerini, insidansını, tedavi yöntemlerini ve sonuçlarını değerlendirmektir. Gereç ve Yöntemler Aralık 2014 ve Şubat 2020 tarihleri arasında perkutan koroner girişim yapılması sırasında stent kaybı gelişen 15 hasta çalışmaya dahil edildi. Otuz gün içinde gözlenen miyokard infarktüsü, baypas ile revaskülarizasyon gereksinimi ve mortalite sonlanım noktaları olarak belirlendi. Bulgular Stent kaybı insidansı %0.15’dır. Çalışmaya dahil edilen hastaların ortalama yaşı 59.87 ± 8.67 olup hastaların 12’si (%80) erkek idi. Üç hastada stent aynı yere implante edilirken, 4 hastada ise farklı bir stent ile ezilerek damara yapıştırıldı. Beş hastada küçük balon ile 3 hastada ise kement ile koronerden geri alınmıştır. Bir hastaya koroner arter baypas operasyonu yapıldı. Bir hasta hastanede öldü. Geriye kalan hastalarda 30 günde ölüm, miyokard infarktüsü ve baypas ile revaskülarizasyon gereksinimi gözlenmedi. Altı hastada Tip C, 7 hastada ise Tip B2 lezyon gözlendi. Hastaların 8 tanesinde stent kaybı sirkumfleks arterdeydi. Sonuç Koroner stent kaybı tip B2/C lezyonlarının yanında özellikle sol sirkumfleks arterde daha sık meydana gelmektedir. Girişimsel kardiyologlar stent kaybı durumunda sıyrılan stentin bulunduğu yere göre farklı tedavi yöntemleri olduğunu bilmeli ve güncel veriler ışığında stent kayıplarını başarılı bir şekilde tedavi edebilmelidir.

Incidance, Treatment Options and Outcomes of Stent Loss During Percutaneous Coronary Intervention: A Single-Center Experience

Objective The aim of this study was to evaluate the demographic characteristics, incidence of stent loss, treatment methods and 30-day outcomes of the patients with stent loss duringpercutaneous coronary intervention (PCI).Materialsand MethodsFifteen patients who lost a stent during PCI between December 2014 and February 2020 were included in the study. Outcomes were classified as myocardial infarction,requirement of bypass revascularization and mortality within 30 days.Results In our study, the incidence of stent loss during PCI was 0.15%. Of these patients, 12 (80%) were male. The mean age of the patients was 59.87 ± 8.67 years. In 3 patients, thestent was deployed at the same location, while in 4 patients, stent crush technique is used. The following retrieval methods were used: inflating the small balloon (%33.33)and snare (%20). One patient underwent coronary bypass surgery. One patient died in the hospital. Death, myocardial infarction and requirement of bypass were notobserved in the one-month follow-up in the remaining patients. Six patients had type C and 7 patients had type B2 lesions. Eight of the lesions were in left circumflex artery.Conclusion Coronary stent loss occurs more frequently in the left circumflex artery, and in type B2/C lesions in particular. Interventional cardiologists should know that differenttreatment methods are available for stent loss in lesions according to the location of the stent, and should be able to successfully treat stent loss in the light of the current data.

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