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Updated: Mar 3, 2026
Human Internal Mammary Artery IMA Transplantation and Stenting: A Human Model to Study the Development of In-Stent Restenosis
Published on: May 9, 2012
[Do diabetic patients benefit from bilateral internal mammary artery?]
Francisca Saraiva1, Noélia Vilas Boas1, Mário Jorge Amorim2
1Departamento de Cirurgia e Fisiologia da Faculdade de Medicina da Universidade do Porto, Portugal.
Introduction:
Bilateral internal mammary artery (BIMA) grafting has been associated with increased long term survival when compared to single IMA, but its benefit on diabetic patients remains controversial.
Aims:
To compare long-term survival following BIMA versus single internal mammary artery (SIMA) grafting between diabetic and non-diabetic patients.
Methods:
We retrospectively reviewed all the patients who underwent isolated CABG and received two or more grafts with at least one IMA graft between 2004 and 2013. Mean follow-up was 4 years and maximum 10. Kaplan-Meier analysis was used to compare long-term survival between BIMA and SIMA in both groups (diabetic vs. non-diabetic). Propensity score matching was used to adjust for treatment selection bias.
Results:
1259 out of 3045 eligible patients were diabetic. BIMA was associated with better long-term survival than SIMA on unadjusted analysis in both groups (cumulative survival of 87% vs. 70% in diabetic patients and 89% vs. 79% in non-diabetic patients, respectively). After propensity score matching, BIMA was associated with increased long-term survival in the non-diabetic cohort (n=1042, HR: 0.570 CI95%: 0.342-0.950), but there was no statistically significant difference in the diabetic cohort (n=850, HR: 0.774 CI95% 0.447-1.339). In-hospital mortality and sternal wound infection were low in matching cohorts irrespectively of the number of IMA grafts or diabetes status.
Conclusions:
BIMA grafting appears to be safe for diabetic patients, despite the apparent lack of significant survival advantage.
