Clinical meaning of uncomplicated coronary dissections after stent implantation.
OBJECTIVE
To assess the influence of uncomplicated coronary dissections in the incidence of target vessel revascularization and cardiovascular events after 1 year.


METHODS
Patients treated from June 1996 to December 2000, with data prospectively collected and uncomplicated dissections (G1, n=36), were compared with those patients without dissections (G2, n=871). Data were assessed with SPSS 8.0 statistical software, the outcomes were compared with the Kaplan-Meier curve, and the significance level was assessed using the log-rank test.


RESULTS
Clinical features were similar in both groups: G1 had lower mean reference diameters (P<0.0001), a greater number of patients with type C lesions (P=0.01), a lower final lumen diameter at the end of the procedure (P=0.003), and a greater balloon/artery ratio (P<0.0001). In the multivariate analysis, only the reference diameter and the artery/balloon ratio were independently associated with the presence of residual dissections. No statistically significant difference existed in the incidence of revascularization of the target vessel and major cardiovascular events, at 1-year clinical follow-up, between the 2 groups of patients. Predictors of adverse clinical events at 1 year were the reference diameter, lesion extension, and residual stenosis, rather than the presence of residual dissection.


CONCLUSIONS
Uncomplicated residual dissections after coronary stents are associated with narrower vessels and a higher balloon/artery ratio. Residual dissections are not associated with worse outcomes at 1-year clinical follow-up.
Quadros
Alexandre Schaan de
AS
Instituto de Cardiologia do Rio Grande do Sul, Fundação Universitária de Cardiologia, Porto Alegre, RS, Brazil. pesquisa@cardnet.tche.br
Gottschall
Carlos A M
CA
Sarmento-Leite
Rogério
R
Valler
Lenise
L
Bussmann
André
A
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D003331:Coronary Vessels / Q000293:injuries*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000628:therapy*; D011859:Radiography; D015607:Stents; D016896:Treatment Outcome