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A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
04:30

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis

Published on: May 14, 2013

Coronary endarterectomy and stent removal in patients with in-stent restenosis

Toshihiro Fukui1, Shuichiro Takanashi, Yasuyuki Hosoda

  • 1Department of Cardiovascular Surgery, Shin-Tokyo Hospital, Matsudo City, Chiba, Japan. tm-fukui@gem.hi-ho.ne.jp

The Annals of Thoracic Surgery
|February 1, 2005
PubMed

Insights

Coronary endarterectomy and stent removal with LIMA patch grafting is a safe and effective treatment for in-stent restenosis (ISR) involving diffuse disease. This aggressive surgical approach offers a viable option for complex ISR cases.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Vascular Biology

Background:

  • In-stent restenosis (ISR) is a significant complication following coronary stent implantation.
  • Current treatment options for ISR are debated, necessitating innovative surgical strategies.
  • Aggressive surgical techniques like endarterectomy and stent removal have been developed for complex ISR cases.

Purpose of the Study:

  • To evaluate the safety and efficacy of coronary endarterectomy and stent removal with concomitant coronary artery bypass grafting (CABG) in patients with severe ISR.
  • To assess the feasibility of using the left internal mammary artery (LIMA) as an on-lay patch for reconstruction in this setting.

Main Methods:

  • Retrospective analysis of 11 consecutive patients with severe ISR treated between April 2001 and March 2004.
  • Patients underwent coronary endarterectomy, stent removal, and multivessel CABG, with LIMA used as an on-lay patch.
  • Data included patient demographics, procedural details, and post-procedure outcomes.

Main Results:

  • All 11 patients underwent successful procedures with no in-hospital complications, except for one case of low output syndrome.
  • The target vessel was the left anterior descending artery (LAD) in all patients.
  • Post-procedure angiography confirmed patency of LIMA patches and LAD arteries, with preserved left ventricular function.

Conclusions:

  • Coronary endarterectomy and stent removal, augmented with an on-lay LIMA patch, represent a safe and effective surgical technique.
  • This approach is particularly beneficial for managing ISR characterized by diffuse target vessel disease.
  • The study highlights a viable surgical option for complex ISR cases refractory to conventional treatments.
Abstract

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