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Directional coronary atherectomy plus stent implantation vs. left internal mammary artery bypass grafting for isolated proximal stenosis of the left anterior descending coronary artery
- Source :
- Catheterization and cardiovascular interventions : official journal of the Society for Cardiac AngiographyInterventions. 64(1)
- Publication Year :
- 2004
-
Abstract
- The aim of this study was to compare the short- (30 days) and long-term (or = 30 days) clinical outcomes of left internal mammary artery bypass grafting (LIMA-LAD) and directional coronary atherectomy plus stent implantation (DCA + stent) in the treatment of isolated proximal left anterior descending coronary (LAD) lesions. One hundred and twenty-six patients underwent LIMA-LAD and 132 consecutive patients underwent DCA + stenting. The primary endpoint was the incidence of short- and long-term major adverse cardiac events (MACE); the secondary endpoints included any periprocedural events and long-term target vessel revascularization (TVR). We found no significant between-treatment difference in the occurrence of short-term MACE, and the long-term MACE rate per 100 person-years was 3.0 in the LIMA-LAD group and 4.6 in the DCA + stent group. After 5-year follow-up, 79% of the patients in the DCA + stent group and 89% of those in the LIMA-LAD group were still MACE-free. The risk of any periprocedural events was six times lower in the DCA + stent group, and the risk of TVR was six times higher. We conclude that both procedures lead to good short- and long-term follow-up results in isolated proximal LAD disease. As fewer periprocedural events and more TVRs occur after DCA + stenting than after LIMA-LAD, they can be considered valuable alternatives to each other.
Details
- ISSN :
- 15221946
- Volume :
- 64
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Catheterization and cardiovascular interventions : official journal of the Society for Cardiac AngiographyInterventions
- Accession number :
- edsair.pmid..........6987b67184475a5fb69b4914f7fd87c9