Drug-eluting stents for the percutaneous treatment of the anastomosis of the left internal mammary graft to left anterior descending artery

Dennis Zavalloni, Marco L. Rossi, Melania Scatturin, Emanuela Morenghi, Daniela Soregaroli, Annamaria Municino, Gabriele L. Gasparini, Veronica Lisignoli, Cristina Barbaro, Patrizia Presbitero

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

BACKGROUND: Data on the treatment of left internal mammary to left anterior descending artery (LIMA-to-LAD) anastomotic disease are scarce and not homogeneous. Both surgery and percutaneous interventions (PCI) have been attempted, but the most effective treatment has not yet been established. In particular, should PCI be performed, the role of stenting seems to be limited by less favorable results than in other subsets of lesions. OBJECTIVE: To assess the clinical impact of drug-eluting stent (DES) use in this particular subset of lesions. METHODS: We describe a cohort of patients treated with PCI on LIMA-to-LAD anastomoses, reporting acute 1-year clinical and angiographic outcomes. The clinical impact of DES use was evaluated as the requirement for target lesion revascularizations (TLR). RESULTS: Fifty-six consecutive patients were evaluated. Acute procedural success was achieved in 52 patients (92.8%). Plain balloon angioplasty allowed acute procedural success in 15 patients (28.8%), whereas stenting was required in 37 patients (71.2%) with suboptimal results or to treat complications. Bare-metal stents (BMS) were used in 17 and DES in 20 patients, without differences in acute results. One-year clinical follow-up was available in 96.1% of patients. TLR were needed in 17.3% of patients. No significant differences were detected in TLR rates after treatment with BMS and DES (26.6% vs. 25%; P=0.99). Two late stent thromboses were observed after DES deployment. CONCLUSION: PCI of the stenoses of LIMA-to-LAD anastomoses with DES did not provide any clinical improvement over BMS use in long-term outcomes; DES use was associated with some cases of late thrombosis.

Original languageEnglish
Pages (from-to)495-500
Number of pages6
JournalCoronary Artery Disease
Volume18
Issue number6
DOIs
Publication statusPublished - Sep 2007

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Drug-Eluting Stents
Breast
Arteries
Transplants
Stents
Metals
Therapeutics
Thrombosis
Balloon Angioplasty
Pathologic Constriction

Keywords

  • Arterial bypass
  • Bypass anastomosis
  • Drug-eluting stents
  • Percutaneous interventions

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Drug-eluting stents for the percutaneous treatment of the anastomosis of the left internal mammary graft to left anterior descending artery. / Zavalloni, Dennis; Rossi, Marco L.; Scatturin, Melania; Morenghi, Emanuela; Soregaroli, Daniela; Municino, Annamaria; Gasparini, Gabriele L.; Lisignoli, Veronica; Barbaro, Cristina; Presbitero, Patrizia.

In: Coronary Artery Disease, Vol. 18, No. 6, 09.2007, p. 495-500.

Research output: Contribution to journalArticle

Zavalloni, D, Rossi, ML, Scatturin, M, Morenghi, E, Soregaroli, D, Municino, A, Gasparini, GL, Lisignoli, V, Barbaro, C & Presbitero, P 2007, 'Drug-eluting stents for the percutaneous treatment of the anastomosis of the left internal mammary graft to left anterior descending artery', Coronary Artery Disease, vol. 18, no. 6, pp. 495-500. https://doi.org/10.1097/MCA.0b013e3282cf4ba9
Zavalloni, Dennis ; Rossi, Marco L. ; Scatturin, Melania ; Morenghi, Emanuela ; Soregaroli, Daniela ; Municino, Annamaria ; Gasparini, Gabriele L. ; Lisignoli, Veronica ; Barbaro, Cristina ; Presbitero, Patrizia. / Drug-eluting stents for the percutaneous treatment of the anastomosis of the left internal mammary graft to left anterior descending artery. In: Coronary Artery Disease. 2007 ; Vol. 18, No. 6. pp. 495-500.
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abstract = "BACKGROUND: Data on the treatment of left internal mammary to left anterior descending artery (LIMA-to-LAD) anastomotic disease are scarce and not homogeneous. Both surgery and percutaneous interventions (PCI) have been attempted, but the most effective treatment has not yet been established. In particular, should PCI be performed, the role of stenting seems to be limited by less favorable results than in other subsets of lesions. OBJECTIVE: To assess the clinical impact of drug-eluting stent (DES) use in this particular subset of lesions. METHODS: We describe a cohort of patients treated with PCI on LIMA-to-LAD anastomoses, reporting acute 1-year clinical and angiographic outcomes. The clinical impact of DES use was evaluated as the requirement for target lesion revascularizations (TLR). RESULTS: Fifty-six consecutive patients were evaluated. Acute procedural success was achieved in 52 patients (92.8{\%}). Plain balloon angioplasty allowed acute procedural success in 15 patients (28.8{\%}), whereas stenting was required in 37 patients (71.2{\%}) with suboptimal results or to treat complications. Bare-metal stents (BMS) were used in 17 and DES in 20 patients, without differences in acute results. One-year clinical follow-up was available in 96.1{\%} of patients. TLR were needed in 17.3{\%} of patients. No significant differences were detected in TLR rates after treatment with BMS and DES (26.6{\%} vs. 25{\%}; P=0.99). Two late stent thromboses were observed after DES deployment. CONCLUSION: PCI of the stenoses of LIMA-to-LAD anastomoses with DES did not provide any clinical improvement over BMS use in long-term outcomes; DES use was associated with some cases of late thrombosis.",
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T1 - Drug-eluting stents for the percutaneous treatment of the anastomosis of the left internal mammary graft to left anterior descending artery

AU - Zavalloni, Dennis

AU - Rossi, Marco L.

AU - Scatturin, Melania

AU - Morenghi, Emanuela

AU - Soregaroli, Daniela

AU - Municino, Annamaria

AU - Gasparini, Gabriele L.

AU - Lisignoli, Veronica

AU - Barbaro, Cristina

AU - Presbitero, Patrizia

PY - 2007/9

Y1 - 2007/9

N2 - BACKGROUND: Data on the treatment of left internal mammary to left anterior descending artery (LIMA-to-LAD) anastomotic disease are scarce and not homogeneous. Both surgery and percutaneous interventions (PCI) have been attempted, but the most effective treatment has not yet been established. In particular, should PCI be performed, the role of stenting seems to be limited by less favorable results than in other subsets of lesions. OBJECTIVE: To assess the clinical impact of drug-eluting stent (DES) use in this particular subset of lesions. METHODS: We describe a cohort of patients treated with PCI on LIMA-to-LAD anastomoses, reporting acute 1-year clinical and angiographic outcomes. The clinical impact of DES use was evaluated as the requirement for target lesion revascularizations (TLR). RESULTS: Fifty-six consecutive patients were evaluated. Acute procedural success was achieved in 52 patients (92.8%). Plain balloon angioplasty allowed acute procedural success in 15 patients (28.8%), whereas stenting was required in 37 patients (71.2%) with suboptimal results or to treat complications. Bare-metal stents (BMS) were used in 17 and DES in 20 patients, without differences in acute results. One-year clinical follow-up was available in 96.1% of patients. TLR were needed in 17.3% of patients. No significant differences were detected in TLR rates after treatment with BMS and DES (26.6% vs. 25%; P=0.99). Two late stent thromboses were observed after DES deployment. CONCLUSION: PCI of the stenoses of LIMA-to-LAD anastomoses with DES did not provide any clinical improvement over BMS use in long-term outcomes; DES use was associated with some cases of late thrombosis.

AB - BACKGROUND: Data on the treatment of left internal mammary to left anterior descending artery (LIMA-to-LAD) anastomotic disease are scarce and not homogeneous. Both surgery and percutaneous interventions (PCI) have been attempted, but the most effective treatment has not yet been established. In particular, should PCI be performed, the role of stenting seems to be limited by less favorable results than in other subsets of lesions. OBJECTIVE: To assess the clinical impact of drug-eluting stent (DES) use in this particular subset of lesions. METHODS: We describe a cohort of patients treated with PCI on LIMA-to-LAD anastomoses, reporting acute 1-year clinical and angiographic outcomes. The clinical impact of DES use was evaluated as the requirement for target lesion revascularizations (TLR). RESULTS: Fifty-six consecutive patients were evaluated. Acute procedural success was achieved in 52 patients (92.8%). Plain balloon angioplasty allowed acute procedural success in 15 patients (28.8%), whereas stenting was required in 37 patients (71.2%) with suboptimal results or to treat complications. Bare-metal stents (BMS) were used in 17 and DES in 20 patients, without differences in acute results. One-year clinical follow-up was available in 96.1% of patients. TLR were needed in 17.3% of patients. No significant differences were detected in TLR rates after treatment with BMS and DES (26.6% vs. 25%; P=0.99). Two late stent thromboses were observed after DES deployment. CONCLUSION: PCI of the stenoses of LIMA-to-LAD anastomoses with DES did not provide any clinical improvement over BMS use in long-term outcomes; DES use was associated with some cases of late thrombosis.

KW - Arterial bypass

KW - Bypass anastomosis

KW - Drug-eluting stents

KW - Percutaneous interventions

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