Percutaneous Stent Implantation for Treating Multivessel Coronary Disease in Patients with and without Involvement of the Proximal Segment of the Anterior Descending Coronary Artery

Abstract

Objective -To assess coronary stent placement in patients with multivessel coronary disease and involvement of the proximal portion of the anterior descending coronary artery. Methods -We retrospectively analyzed the in-hospitalPatients with multivessel coronary disease who have lesion in the proximal segment of the anterior descending coronary artery have a shorter event-free survival when treated with balloon catheter coronary angioplasty as compared with those who do not have lesion in that arterial segment 1,2 . This fact limited the use of that technique, and the surgical procedure became the preferential option for treating that type of patient 3 .Stents, however, are currently used in more than 70% of the percutaneous coronary procedures and have been shown to provide a great number of benefits, such as the possibility of treating more complex lesions, the control of the complications of coronary dilation, a better clinical evolution, and a significant reduction in restenosis 4,5 . In addition, a substudy of the Stent Restenosis Study 6 , which randomized patients with single-vessel coronary disease for balloon catheter coronary angioplasty or stent placement, showed that the most benefited subgroup in regard to restenosis comprised patients with lesion in the anterior descending coronary artery treated with stents.However, it has not yet been clarified whether in patients with multivessel coronary disease, stent placement may provide similar results in the groups with and without obstruction of the proximal segment of the anterior descending coronary artery. Therefore, in our study, we compared the in-hospital results and the clinical evolution of the patients who had undergone stent implantation.