1. Immediate and Long-Term Results of Drug-Eluting Stents in Mammary Artery Grafts
- Author
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Antonio Cea Gutiérrez, Monica Fernandez Quero, Ángel Sánchez-Recalde, José Antonio Sevillano Fernández, Javier Botas, Vicens Serra, José Ramón López Mínguez, Fernando Alfonso, José Moreu, Armando Pérez de Prado, José Ramón Rumoroso, José M. de la Torre, Ramón López-Palop, Eduardo Pinar, Valeriano Ruiz-Quevedo, José Antonio Baz, Felipe Hernández, Garikoitz Lasa, Manuel Jiménez Navarro, Joan Antoni Gómez-Hospital, Iñigo Lozano, Alfonso Suarez Cuervo, Javier Pineda, Koldobika Garcia San Roman, Ana Serrador, Amparo Benedicto, and Javier Martín Moreiras more...
- Subjects
Male ,medicine.medical_specialty ,Percutaneous ,Paclitaxel ,Internal medicine ,medicine ,Humans ,Zotarolimus ,Myocardial infarction ,Everolimus ,Internal Mammary-Coronary Artery Anastomosis ,Aged ,Sirolimus ,Ejection fraction ,business.industry ,Unstable angina ,Drug-Eluting Stents ,Middle Aged ,medicine.disease ,Surgery ,Treatment Outcome ,Heart failure ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Immunosuppressive Agents ,medicine.drug - Abstract
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 (Q 25 : 23.7 to Q 75 : 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. more...
- Published
- 2015