title: Favorable impact of stents after emergent coronary artery bypass for failed angioplasty.
abstract: BACKGROUND
  This study was undertaken to determine the impact of the use and availability of coronary stents on outcomes in patients requiring emergent coronary artery bypass graft (CABG) surgery following a failed percutaneous transluminal coronary angioplasty (PTCA).
  
  
  METHODS
  Patients were divided into two groups based on the year of their CABG for a failed PTCA and the availability of stents: group 1, 1992 to 1994, stents not available (n = 34); and group 2, 1995 to 1997, stents available (n = 26).
  
  
  RESULTS
  CABG patients in the group where stents were not available were more likely to have had an abrupt coronary occlusion (26 of 34 versus 3 of 26; p < 0.0001) and less likely to have had a dissection (8 of 34 versus 23 of 26; p < 0.0001) as their indication for emergent CABG. Patients in the stent era had a lower incidence of perioperative myocardial infarction (5 of 26 versus 17 of 34; p < 0.01) and a decreased mortality rate (0 of 26 versus 6 of 34; p < 0.03). In the 9 patients where stents were employed, patency of the lumen was restored in 8 patients and there was only 1 myocardial infarction.
  
  
  CONCLUSIONS
  Stents have had a favorable impact on patients requiring an emergent CABG following a failed PTCA.
authors.affiliation: Department of Cardiothoracic Surgery, Boston Medical Center, and Boston University School of Medicine, Massachusetts 02118, USA.
authors.forename: H L
authors.initials: HL
authors.lastname: Lazar
authors.forename: Y
authors.initials: Y
authors.lastname: Bao
authors.forename: D
authors.initials: D
authors.lastname: Lancaster
authors.forename: O M
authors.initials: OM
authors.lastname: Shapira
authors.forename: G S
authors.initials: GS
authors.lastname: Aldea
authors.forename: R J
authors.initials: RJ
authors.lastname: Shemin
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000401:mortality / Q000601:surgery*; D015906:Angioplasty, Balloon, Coronary; D003323:Coronary Aneurysm / Q000401:mortality / Q000601:surgery*; D001026:Coronary Artery Bypass; D004630:Emergencies; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000601:surgery*; D010043:Outcome and Process Assessment, Health Care; D011183:Postoperative Complications / Q000401:mortality; D012189:Retrospective Studies; D015607:Stents; D015996:Survival Rate; D017211:Treatment Failure