title: Clinical outcomes following stent implantation in internal mammary artery grafts.
abstract: We evaluated our experience with percutaneous coronary intervention (PCI) of internal mammary artery (IMA) grafts. From the institution's database we identified 288 patients with 311 IMA lesions. Of these, 82 (26.4%) had stents placed during PCI. Angiographic success was 92%. Mortality at 1 month was 1.7%, myocardial infarction (MI) 15.7%, and target lesion revascularization (TLR) 0.4%. Cumulative 1-year event rates were mortality 6.4%, MI 20.4%, and TLR 8.0%. TLR rates were significantly higher in the stented lesions than lesions treated with angioplasty alone (19.2% vs. 4.9%; P = 0.004). The higher TLR rate in stented lesions was most apparent at the anastomotic site (25.0% vs. 4.2%; P = 0.006). Percutaneous revascularization of IMA grafts can be performed safely with high procedural success and excellent short- and long-term results. Stenting, particularly at the anastomotic site, was associated with significantly greater rates of TLR than angioplasty alone.
authors.affiliation: Department of Cardiology, Washington Hospital Center, Washington, DC 20010, USA.
authors.forename: Arvind K
authors.initials: AK
authors.lastname: Sharma
authors.forename: Scott
authors.initials: S
authors.lastname: McGlynn
authors.forename: Sue
authors.initials: S
authors.lastname: Apple
authors.forename: Ellen
authors.initials: E
authors.lastname: Pinnow
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Canos
authors.forename: Natalie
authors.initials: N
authors.lastname: Gevorkian
authors.forename: Mihaela
authors.initials: M
authors.lastname: Tebeica
authors.forename: Luis
authors.initials: L
authors.lastname: Gruberg
authors.forename: Augusto D
authors.initials: AD
authors.lastname: Pichard
authors.forename: Joseph
authors.initials: J
authors.lastname: Lindsay
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006083:Graft Occlusion, Vascular / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents; D015996:Survival Rate; D016896:Treatment Outcome