CLINICAL STUDIES
Percutaneous revascularization of the internal mammary artery graft: short- and long-term outcomes
Luis Gruberg, MDa,b,
George Dangas, MD, PhD, FACC, FESCa,b,
Roxana Mehran, MD, FACC, FESCa,b,
Mun K. Hong, MD, FACCa,b,
Ron Waksman, MD, FACCa,b,
Gary S. Mintz, MD, FACCa,b,
Kenneth M. Kent, MD, PhD, FACCa,b,
Augusto D. Pichard, MD, FACCa,b,
Lowell F. Satler, MD, FACCa,b,
Alexandra J. Lansky, MDa,b,
Gregg W. Stone, MD, FACCa,b and
Martin B. Leon, MD, FACCa,b
a Cardiovascular Research Foundation, New York, New York, USA
b Cardiac Catheterization Laboratory, Washington Hospital Center, Washington, DC, USA
Manuscript received August 5, 1999;
revised manuscript received October 27, 1999,
accepted December 7, 1999.
Reprint requests and correspondence: Dr. George Dangas, Cardiovascular Research Foundation, 6th floor, 55 East 59th Street, New York, NY 10022
gdangas{at}compuserve.com
OBJECTIVES
We evaluated the short- and long-term clinical outcomes after percutaneous revascularization of the internal mammary artery (IMA) graft.
BACKGROUND
Previous reports in a relatively small number of patients have indicated the safety of balloon angioplasty for the treatment of stenoses in the IMA graft. However, the use of alternative interventional techniques and their long-term results have not yet been evaluated.
METHODS
We analyzed the in-hospital and one-year clinical outcomes of 174 consecutive patients who underwent percutaneous revascularization of 202 lesions located in the IMA graft, by either balloon angioplasty or stenting.
RESULTS
Anastomotic lesions were evident in 128 cases (63%), and they were more commonly treated with balloon angioplasty (116/128, 91%), whereas lesions located at the ostium (n = 16, 8%) were more frequently treated with stents (11/16, 69%). Procedural success was 97% with excellent in-hospital outcome: 0.6% mortality rate, no Q-wave myocardial infarction (MI) and 0.6% rate of urgent bypass surgery. Cumulative one-year rates were: mortality 4.4%, MI 2.9% and target lesion revascularization (TLR) 7.4%.
CONCLUSIONS
Revascularization of the IMA graft can be performed safely, with high procedural success and a low rate of in-hospital complications. Long-term follow-up showed very low TLR rate.
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Abbreviations and Acronyms
| | CABG | = coronary artery bypass graft | | CCS | = Canadian Cardiovascular Society | | CK | = creatine kinase | | IMA | = internal mammary artery | | MI | = myocardial infarction | | MLD | = minimal lumen diameter | | PTA | = percutaneous transluminal angioplasty | | TIMI | = Thrombolysis in Myocardial Infarction | | TLR | = target lesion revascularization |
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T. Nakamura, A. Azuma, T. Sawada, K. Sakamoto, T. Yamano, H. Yaku, and H. Matsubara
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Angiology,
October 1, 2006;
57(5):
643 - 646.
[Abstract]
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