1. Stent-grafts versus drug-eluting stents in arterial aneurysms, insights from the International Coronary Artery Aneurysm Registry (CAAR)
- Author
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Iván J. Núñez-Gil, Enrico Cerrato, Mario Bollati, Luis Nombela-Franco, Belén Terol, Emilio Alfonso-Rodríguez, Santiago J. Camacho-Freire, Pedro A. Villablanca, Ignacio J. Amat Santos, José M. de la Torre-Hernández, Isaac Pascual, Christoph Liebetrau, Benjamín Camacho, Marco Pavani, Roberto Adriano Latini, Ferdinando Varbella, Víctor Alfonso Jiménez Díaz, Davide Piraino, Massimo Mancone, Fernando Alfonso, José Antonio Linares, Jesús M. Jiménez-Mazuecos, Jorge Palazuelos-Molinero, Íñigo Lozano, and Antonio Fernández-Ortiz
- Subjects
Coronary aneurysm ,Registry ,Stent ,Stent graft ,Angioplasty ,Medicine - Abstract
ABSTRACT Introduction and objectives: Coronary artery aneurysms are a complex situation. Our main objective is to describe the frequency of use of covered stents (grafts) for their management, as well as to characterize their long-term results compared to drug-eluting stents. Methods: Ambispective observational study with data from the International Coronary Artery Aneurysm Registry (CAAR) (NCT-02563626). Only patients who received a stent-graft or a drug-eluting stent where the aneurysm occurred were selected. Results: A total of 17 patients received, at least, 1 stent-graft while 196 received 1 drug-eluting in the aneurysmal vessel. Male predominance, a higher rate of dyslipidemia, a past medical history of coronary artery disease, previously revascularized coronary artery disease, and giant aneurysms were reported in the stent-graft cohort. The independent predictive variables of the composite endpoint of all-cause mortality, heart failure, unstable angina, reinfarction, stroke, systemic embolism, bleeding or any aneurysmal complications at the median follow-up of 38 months were suggestive of the existence of connective tissue diseases (HR, 5.94; 95%CI, 1.82-19.37), left ventricular dysfunction ≤ 55% (HR, 1.84; 95%CI, 1.09-3.1), and an acute indication for heart catheterization (HR, 2.98; 95%CI, 1.39-6.3). The use of stent-grafts was not associated with the occurrence of more composite endpoints (23.5% vs 29.6%; P = .598). Conclusions: The use of stent-grafts to treat coronary aneurysms is feasible and safe in the long-term. Randomized clinical trials are needed to decide what the best treatment is for these complex lesions. Keywords: Coronary aneurysm. Registry. Stent. Stent graft. Angioplasty.
- Published
- 2022
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