title: Drug-eluting stents for the treatment of coronary lesions in cardiac transplant vasculopathy: acute and mid-term clinical and angiographic outcomes.
abstract: BACKGROUND
  Cardiac allograft vasculopathy (CAV) is the major cause of graft failure and death in cardiac transplant recipients after transplantation. We aimed to evaluate the clinical and angiographic outcomes of patients with evidence of CAV who were treated percutaneously with drug-eluting stents (DES-PCI).
  
  
  METHODS
  Between December 2002 and September 2005, we reviewed the baseline procedural characteristics and the clinical outcome of consecutive cardiac transplanted recipients with evidence of CAV treated with DES-PCI, eligible for at least 9 months of follow-up.
  
  
  RESULTS
  Fifteen consecutive patients received a total of 18 coronary DESs. Total treated lesions were 20; 12 (60%) involved the left anterior descending artery. CAV was focal in nine patients, diffuse in five patients, and mixed in only one patient. Mean time interval from transplantation to DES implantation was 126 +/- 44 months. Angiographic and procedural success was 100%. There were no adverse in-hospital events. During follow-up (17.9 +/- 8.4 months), two patients died of noncardiac cause. Six patients required a new percutaneous intervention for a repeat revascularization rate of 40%: one patient underwent target lesion revascularization because of in-DES restenosis, one patient had target vessel revascularization because of a new coronary lesion proximal to the stent. Finally, four more patients underwent repeat DES-PCI in a coronary vessel other than the treated one.
  
  
  CONCLUSIONS
  Although DES implantation seems to be associated with a high procedural success rate and a low restenosis rate, the repeat revascularization rate due to CAV progression remains in nearly half of our study patients.
authors.affiliation: Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy. giuseppe.tarantini.1@unipd.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tarantini
authors.forename: Enrico
authors.initials: E
authors.lastname: Favaretto
authors.forename: Arianna
authors.initials: A
authors.lastname: Gardin
authors.forename: Massimo
authors.initials: M
authors.lastname: Napodano
authors.forename: Gianbattista
authors.initials: G
authors.lastname: Isabella
authors.forename: Marco
authors.initials: M
authors.lastname: Panfili
authors.forename: Gino
authors.initials: G
authors.lastname: Gerosa
authors.forename: Sabino
authors.initials: S
authors.lastname: Iliceto
authors.forename: Angelo
authors.initials: A
authors.lastname: Ramondo
mesh_terms: D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D054855:Drug-Eluting Stents; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome