Bilateral internal thoracic artery grafting for peripheral arterial disease patients.
BACKGROUND
Peripheral arterial disease (PAD) is known to have a poor prognosis. Some reports have also described poor late results after coronary artery bypass grafting (CABG). However, there have been few reports about whether bilateral internal thoracic artery grafting improves the long-term survival of PAD patients after CABG. We performed this study to clarify whether or not this is the case.


METHODS
One hundred and thirty-six PAD patients who underwent elective CABG with two or more grafts were enrolled in this study. Patients were divided into two groups, 71 patients in the bilateral internal thoracic artery (BITA) group and 65 patients in the single internal thoracic artery (SITA) group. The maximum follow-up period was 19 years, with a mean of 5.7 ± 4.4 years.


RESULTS
We investigated the long-term results based on three factors; survival, freedom from cardiac death, and freedom from cardiac events. The 3-, 5- and 10-year survival rates in the BITA group were 83.0, 74.2, and 43.1%, respectively. And those in the SITA group were 79.4, 67.7, and 32.3%, respectively. There were no significant differences between the two groups (p = 0.5843). There were also no statistically significant differences between the two groups in terms of the freedom from cardiac death (p = 0.8589) or in the freedom from cardiac events (p = 0.9445).


CONCLUSIONS
No long-term advantage was observed for CABG with BITA in comparison to SITA alone in patients with PAD.
Department of Cardiovascular Surgery, Kumamoto Central Hospital, 1-5-1 Tainoshima, Kumamoto, 862-0965, Japan, nakatsu-taro@hotmail.co.jp.
Taro
T
Nakatsu
Nobushige
N
Tamura
Shigeki
S
Yanagi
Shoichi
S
Kyo
Takaaki
T
Koshiji
Ryuzo
R
Sakata
D000368:Aged; D047549:Coronary Artery Bypass, Off-Pump; D003324:Coronary Artery Disease / Q000150:complications / Q000401:mortality; D005260:Female; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000150:complications / Q000601:surgery*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D020521:Stroke / Q000150:complications; D015996:Survival Rate; D016896:Treatment Outcome