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[Long-term follow-up after implantation of a coronary endoprosthesis]
1Division de Cardiologie, Centre Hospitalier Universitaire Vaudois, Lausanne, Suisse.
Insights
Coronary stenting shows long-term benefits over angioplasty, with lower restenosis and revascularization needs. However, stenting coronary artery bypass grafts resulted in worse outcomes compared to native vessels.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
Background:
- Coronary stenting demonstrates reduced need for revascularization and lower restenosis rates compared to conventional percutaneous angioplasty.
- These benefits of coronary stenting are sustained over the long term.
Purpose of the Study:
- To analyze the long-term clinical and angiographic outcomes of patients undergoing coronary stenting.
- To compare the efficacy and safety of coronary stenting in native arteries versus vein grafts.
Main Methods:
- A prospective study evaluating 129 patients with a minimum 3-year follow-up.
- Assessment of major clinical and angiographic complications, restenosis rates, and survival.
Main Results:
- At 6 months, 20% of patients experienced major clinical complications and 20% had restenosis.
- Long-term follow-up revealed major adverse cardiac events in 49% of patients (16% death, 5% infarction, 12% bypass graft, 16% repeat angioplasty).
- Patients treated for coronary artery bypass grafts had significantly lower survival (60% vs. 88%) and higher complication and revascularization rates.
Conclusions:
- Coronary stenting offers a low late stent revascularization rate.
- Survival is significantly higher, and complication rates are lower when stenting native vessels compared to coronary artery bypass grafts.
Unlabelled:
The authors analysed the long-term clinical and angiographic follow-up of patients after coronary stenting for the treatment of coronary stenosis of a native artery or vein graft.
Background:
The need for revascularization at 6 months and the restenosis rate were decreased after coronary stenting, compared to the conventional percutaneous angioplasty. This benefit appears to persist in the longer term.
Method:
The incidence of major clinical and angiographic complications was evaluated in 129 patients with a minimum follow-up of 3 years.
Results:
At 6 months, 20% of patients presented a major clinical complication and restenosis was documented in 20% of cases. In the long-term, a major cardiac event was observed in 49% of cases (death: 16%, infarction: 5%, coronary artery bypass graft: 12% and another angioplasty: 16%). Patients treated by stenting during coronary artery bypass graft had a significantly lower survival (60% versus 88%), and a higher incidence of major clinical complications (55% versus 18%), and a higher stent revascularization rate (41% versus 16%).
Conclusion:
The late stent revascularization rate was low. Overall survival was significantly higher in patients treated for a native vessel than in those treated for a coronary artery bypass graft. The complication rate and stent revascularization rate were also significantly lower.