Follow-up patency of side branches covered by intracoronary Palmaz-Schatz stent.
To assess the risk of late side branch occlusion after Palmaz-Schatz stent deployment, we analyzed the angiographic evolution of 62 patients treated by successful stent implantation who had a total of 85 side branches starting from the stented segment. Side branches were considered minor (n = 39) when the diameter was < 1 mm and intermediate (n = 46) when the vessel had > or = 1 mm diameter. One angiographic follow-up study was available in all patients at 8 +/- 5 months. Eight minor branches presented some degree of stenosis at origin before stent deployment (4 totally occluded). After stent deployment, 32 (82%) of 39 remained unchanged and 3 became occluded. Late progression at origin occurred in 4 of 34 (3 occluded). Before stent deployment, 48% of the intermediate branches had some compromise degree at their starting point (1 totally occluded). Eight of 45 intermediate branches became occluded after stent implantation. Late progression at origin happened in 5 of 32 branches (2 occluded). Some degree of follow-up stenosis regression at the origin was observed in 22 (26%) of 85 arteries. Neither clinical nor angiographic factors could be identified as predictors of late side branch occlusion or stenosis progression at its origin. Later occlusion or progression at origin of a side branch covered by a Palmaz-Schatz stent seems to be an uncommon occurrence (7% and 12% respectively) that cannot be predicted by angiographic or clinical factors. On the contrary, regression at follow-up of a side branch-origin stenosis can also come about.
Pan
M
M
Hospital Reina Sofía, University of Córdoba, Spain.
Medina
A
A
Suárez de Lezo
J
J
Romero
M
M
Melián
F
F
Pavlovic
D
D
Hernández
E
E
Segura
J
J
Marrero
J
J
Torres
F
F
D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D015607:Stents; D014654:Vascular Patency