Late patency of the left internal thoracic artery graft in patients with and without previous successful percutaneous transluminal coronary angioplasty

Abstract

The aim of this study was to compare early and late graft patency in patients with and without previous successful PTCA. Of the 70 patients who received both early and late follow-up angiography, 13 patients who had received successful PTCA at the left anterior descending coronary artery (LAD) before CABG (group I) and 31 patients who had not received preoperative PTCA in any vessel (group II) were retrospectively reviewed. There were no significant differences in patient characteristics including major coronary risk factors. The mean duration between the operation and control angiography was 35+/-23 months in group I and 36+/-19 months in group II (P=0.90). Occlusions of the LITA graft were observed in four patients of group I and in four patients of group II. Cumulative patencies of the LITA graft were 54% in group I and 83% in group II (P=0.12). The late patency rate of the LITA graft bypassed to the LAD in patients that received previous successful PTCA in the coronary artery tended to be lower than in patients without previous PTCA. This result should be confirmed by further prospective studies.

Impact of prior intracoronary stenting on late outcomes of coronary artery bypass surgery in diabetics with triple-vessel disease

“…29 Together, increased inflammation and endothelial dysfunction can jeopardize graft patency and negatively affect CABG outcomes, as reported in a recent small study showing a trend toward reduced patency of grafts from the internal thoracic artery to the left anterior descending artery in patients with left anterior descending artery stents. 18 …”

“…6,8–12 Recent reports have postulated that such patients have increased inflammation and endothelial injury, 13–17 and that the grafts in those who have undergone CABG and have pre-existing intracoronary stents may have suboptimal placement and patency. 18 We hypothesized that in diabetic patients with triple-vessel disease, a history of PCI with stent placement portends poorer long-term survival, given the established endothelial dysfunction in diabetic patients 19,20 and the significant CAD burden associated with triple-vessel disease. We leveraged the availability of a real-world cardiac surgery registry with late-mortality follow-up, to assess the impact of prior stenting on 5-year all-cause mortality in patients who undergo primary CABG.…”

Gender Differences in Clinical and Angiographic Outcomes After Coronary Artery Bypass Surgery

“…Kamiya et al reported that the patency rates of left ITA bypasses to the LAD were lower in patients with previous PCI than those in patients without previous PCI. 41 They estimated that inflammation triggered by stent implantation and in-stent restenosis itself might be the cause of the lower patency rates in patients with previous PCI. In contrast, age was the only protective factor against graft occlusion.…”

Perioperative predictors of early silent coronary graft occlusion after direct myocardial revascularisation

“…в среднем через 36 мес. после операции проходимость левой внутренней грудной артерии к ранее стентированным артериям была ниже, чем к КА без предшествующего эндоваскулярного вмешательства, хотя эти различия оказались статистически недостоверны [18]. M.C.…”