TY - JOUR
T1 - Clinical outcome of patients undergoing multivessel coronary stent implantation
AU - Mathew, Verghese
AU - Rihal, Charanjit S.
AU - Berger, Peter B.
AU - Bell, Malcolm R.
AU - Garratt, Kirk N.
AU - Holmes, David R.
PY - 1998/3/13
Y1 - 1998/3/13
N2 - Objectives: To evaluate the outcome of patients undergoing multivessel coronary stent implantation. Background: Percutaneous transluminal coronary angioplasty has been shown to be an effective treatment for multivessel coronary artery disease, although the need for repeat revascularization continues to be a limitation. Intracoronary stent placement has been shown to reduce the need for subsequent revascularization. Methods: Seventy-seven patients without prior coronary artery bypass grafting (CABG) undergoing multivessel coronary revascularization in which stents were placed in all treated segments over a 5 year period at our institution were identified. Clinical and angiographic characteristics and outcomes were analyzed. Results: One hundred and eighty-eight coronary lesions were successfully treated (2.1 ± 0.3 treated vessels/patient, 2.4 ± 0.6 treated lesions/patient) using 2.8 ± 1.2 stents/patient (range 2-9) and 1.4 ± 0.8 stents/vessel (range 1-6). Procedural success rate [angiographic success without in-hospital death, Q-wave myocardial infarction (Q-wave MI) or CABG] was achieved in 76 of 77 patients (98.7%). Anatomically complete revascularization was achieved in 46 (59.7%) patients. Modified ACC/AHA Type B2 and C lesions comprised 75.5% of the 188 lesions. The left anterior descending artery was treated in 57 (74.0%) patients. The indication for stent placement was dissection or threatened/abrupt closure in 54 segments (28.8%). In-hospital events included death in one patient (1.3%); no patient suffered a Q-wave MI or required CABG. Stent occlusion occurred in two (2.6%) patients, and repeat percutaneous intervention of the target vessel was also required in these two patients. Any of these adverse events occurred in three(3.9%) patients. No further events occurred after hospital discharge in the 30 days after the procedure. Of hospital survivors (n=76), adverse events at 6 months included death in two patients (2.6%), MI in two (2.6%), CABG in six (7.9%); nine (11.8%) patients underwent repeat percutaneous intervention and 15 (19.7%) underwent any revascularization. Conclusions: Multivessel coronary stent placement is associated with an excellent procedural success rate despite a high rate of adverse lesion characteristics, and a low rate of death or MI during follow-up. The need for further revascularization compares favorably with published rates with multivessel FICA and single stent implantation for discrete de novo lesions.
AB - Objectives: To evaluate the outcome of patients undergoing multivessel coronary stent implantation. Background: Percutaneous transluminal coronary angioplasty has been shown to be an effective treatment for multivessel coronary artery disease, although the need for repeat revascularization continues to be a limitation. Intracoronary stent placement has been shown to reduce the need for subsequent revascularization. Methods: Seventy-seven patients without prior coronary artery bypass grafting (CABG) undergoing multivessel coronary revascularization in which stents were placed in all treated segments over a 5 year period at our institution were identified. Clinical and angiographic characteristics and outcomes were analyzed. Results: One hundred and eighty-eight coronary lesions were successfully treated (2.1 ± 0.3 treated vessels/patient, 2.4 ± 0.6 treated lesions/patient) using 2.8 ± 1.2 stents/patient (range 2-9) and 1.4 ± 0.8 stents/vessel (range 1-6). Procedural success rate [angiographic success without in-hospital death, Q-wave myocardial infarction (Q-wave MI) or CABG] was achieved in 76 of 77 patients (98.7%). Anatomically complete revascularization was achieved in 46 (59.7%) patients. Modified ACC/AHA Type B2 and C lesions comprised 75.5% of the 188 lesions. The left anterior descending artery was treated in 57 (74.0%) patients. The indication for stent placement was dissection or threatened/abrupt closure in 54 segments (28.8%). In-hospital events included death in one patient (1.3%); no patient suffered a Q-wave MI or required CABG. Stent occlusion occurred in two (2.6%) patients, and repeat percutaneous intervention of the target vessel was also required in these two patients. Any of these adverse events occurred in three(3.9%) patients. No further events occurred after hospital discharge in the 30 days after the procedure. Of hospital survivors (n=76), adverse events at 6 months included death in two patients (2.6%), MI in two (2.6%), CABG in six (7.9%); nine (11.8%) patients underwent repeat percutaneous intervention and 15 (19.7%) underwent any revascularization. Conclusions: Multivessel coronary stent placement is associated with an excellent procedural success rate despite a high rate of adverse lesion characteristics, and a low rate of death or MI during follow-up. The need for further revascularization compares favorably with published rates with multivessel FICA and single stent implantation for discrete de novo lesions.
KW - Intracoronary stents
KW - Multivessel coronary disease
KW - Percutaneous transluminal coronary angioplasty
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U2 - 10.1016/S0167-5273(97)00333-1
DO - 10.1016/S0167-5273(97)00333-1
M3 - Article
C2 - 9579810
AN - SCOPUS:0032513077
SN - 0167-5273
VL - 64
SP - 1
EP - 7
JO - International Journal of Cardiology
JF - International Journal of Cardiology
IS - 1
ER -