Immediate and Long-Term Results of Drug-Eluting Stents in Mammary Artery Grafts.

Abstract

UNLABELLED:

Percutaneous intervention of a coronary graft is the treatment of choice when the graft fails. The objective is to report the long-term results of drug-eluting stents (DES) in mammary artery grafts (MAG). Patients who had been treated with DES for MAG in 27 centers were selected. The baseline and procedural clinical data were included prospectively, and the follow-up was performed with the patients, families, and medical records. Two hundred and sixty-eight patients were included: age 65.5 ± 10.1 years, diabetes 47.8%, ejection fraction 55.5 ± 14.9%.

INDICATION:

stable angina 28.4%, unstable angina 38.1%, non-ST-elevation myocardial infarction 21.6%, ST-elevation myocardial infarction 5.3%, and heart failure 6.7%; 1.19 ± 0.59 stents/patient were implanted measuring 18.8 ± 8.8 mm in length and 2.68 ± 0.35 mm in diameter. Rapamycin was used in 78 cases (29.1%), paclitaxel in 77 (28.7%), everolimus in 70 (26.1%), zotarolimus in 34 (12.7%), and biolimus in 9 (3.4%). All cases were successful except for 1 in which the patient died 30 minutes after the procedure. There were no other inhospital events. After a follow-up of 41 months (Q25: 23.7 to Q75: 57.8), 24 patients (9%) died of heart-related causes and 20 (7.5%) of noncardiac causes. Repeat revascularization was necessary in 31 cases, and in 1 additional patient, there was total occlusion, which was not treated. These 32 patients represented 11.9% of the total. In conclusion, the implantation of DES in MAG shows very high procedural success and also low long-term event rates.

• Authors: Iñigo Lozano, Ana Serrador, Ramon Lopez-Palop, Garikoitz Lasa, Jose Moreu, Eduardo Pinar, Armando Perez de Prado, Fernando Alfonso, Manuel Jimenez Navarro, Monica Fernandez Quero, Javier Pineda, Javier Martin Moreiras, Koldobika Garcia San Roman, Jose R Lopez Minguez, Alfonso Suarez Cuervo, Antonio Gutierrez, Felipe Hernandez, Jose A Baz, Amparo Benedicto, Jose R Rumoroso, Joan A Gomez-Hospital, Vicens Serra, Jose M de la Torre, Valeriano Ruiz-Quevedo, Javier Botas, Jose A Fernandez, Angel Sanchez-Recalde
• Journal: The American journal of cardiology (Am J Cardiol) Vol. 116 Issue 11 Pg. 1695-9 (Dec 01 2015) ISSN: 1879-1913 [Electronic] United States
• PMID: 26433270 (Publication Type: Journal Article)
• Copyright: Copyright © 2015 Elsevier Inc. All rights reserved.

Chemical References

• Immunosuppressive Agents
• Everolimus
• zotarolimus
• Paclitaxel
• umirolimus
• Sirolimus

Topics

• Aged
• Drug-Eluting Stents
• Everolimus (administration & dosage)
• Female
• Humans
• Immunosuppressive Agents (administration & dosage)
• Internal Mammary-Coronary Artery Anastomosis
• Male
• Middle Aged
• Paclitaxel (administration & dosage)
• Sirolimus (administration & dosage, analogs & derivatives)
• Treatment Outcome