Unrecognized internal mammary artery stenosis treated by percutaneous angioplasty after coronary bypass surgery

Stullman, Walter S.; Hilliard, G.

doi:10.1016/0002-8703(87)90286-9

Cited by 13 publications

(10 citation statements)

References 9 publications

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“…(184/201).5-10 [25][26][27][28][29][30][31][32][33][34][35][36] The overall success rate of first angioplasty was relatively lower in the present study, which may be explained by our inclusion of 12/48 (25%) totally or subtotally occluded internal mammary artery grafts. Most previous reports contained no or only a few cases with totally occluded internal mammary artery grafts.…”

Section: Comparison With Previous Reportsmentioning

confidence: 74%

Initial and subsequent angiographic outcome of percutaneous transluminal angioplasty performed on internal mammary artery grafts.

Ishizaka

Ishizaka²,

Ikari³

et al. 1995

Heart

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Section: Comparison With Previous Reportsmentioning

confidence: 74%

Initial and subsequent angiographic outcome of percutaneous transluminal angioplasty performed on internal mammary artery grafts.

Ishizaka

Ishizaka²,

Ikari³

et al. 1995

Heart

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“…С расширением показаний к использованию вну-тренних грудных артерий для КШ появилось значитель-ное количество сообщений об успешных баллонных дила-тациях стенозов анастомозов как в раннем, так и в отда-ленном послеоперационном периоде, что говорит о ча-стоте подобных осложнений [19]. В то же время большин-ство специалистов едины во мнении, что стенозы и ок-клюзии маммарокоронарных анастомозов являются след-ствием технических ошибок, и не исключают возмож- Примечание.…”

Section: Discussionunclassified

10-year results of coronary artery bypass grafting with microsurgical technique

Акчурин¹,

Shiryaev²,

Galyautdinov³

et al. 2016

Kardiol. serdechno-sosud. khir.

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Преимущества применения операционных микро-скопов, микрохирургических инструментов и тонкого «микрохирургического» шовного материала для сшива-ния артерий малого калибра давно доказаны в рекон-структивной хирургии [16]. В начале 70-х гг. микрохирур-гическая техника была внедрена для манипуляции на ко-ронарных артериях (КА), однако эта методика не получи-ла распространения, так как требовала переквалифика-ции хирургов. Кроме того, ошибочно принятое в качестве операции выбора, на протяжении 20 лет, только аутове-нозное коронарное шунтирование (КШ) чаще всего не требовало значительного оптического увеличения и ис-пользования микрохирургических методов [10,20]. Более широкое внедрение множественного аутоартериального КШ, использование бимаммарных, Y-образных кон-струкций, желудочно-сальниковых артерий требует по-вышения прецизионности вмешательства, что обусловли-вает перспективность применения методов микрохирур-гии [15]. С 1985 г. в нашей клинике микрохирургическая техника рутинно применяется в коронарной хирургии [1][2][3]. Однако остается открытым вопрос об эффектив-ности применения операционного микроскопа по срав-нению со стандартной техникой выполнения дистальных анастомозов (ДА). Aim. To compare long-term outcomes of coronary artery bypass surgery using microsurgical and standard technique for distal anastomoses. Material and methods. It was analyzed 10-year results of 193 patients who underwent elective coronary artery bypass grafting (CABG) in 1999-2001. Analysis included survival, angina recurrence, incidence of non-fatal myocardial infarction and reoperation rate. Initially patients were randomized into two groups: microsurgical technique (n=89) and conventional technique (n=104). Survival analysis was performed using Kaplan-Meier method. Results. 10-year survival in case of microsurgical method compared with conventional technique was 84,3 and 70,2% (p=0,03); non-fatal myocardial infarction incidence -9,6 and 21,2% (p=0,03); angina recurrence -14,4 and 25,5% (p=ns); reoperation rate -10,8 and 22,3% (p=0,04), respectively. Conclusion. The use of surgical microscope and microsurgical technique decreases mortality, non-fatal myocardial infarction incidence and reoperation rate. Thus, the use of large optical magnification has a positive effect on survival and efficacy of coronary surgery during follow-up. ИШЕМИЧЕСКАЯ БОЛЕЗНЬ СЕРДЦА 10-year results of coronary artery bypass grafting with microsurgical technique

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“…Ostial stenoses of IMA grafts are extremely rare lesions since only five cases undergoing angioplasty have been reported [3][4][5][6][7]. The pathophysiological mechanism resulting in such lesions is highly controversial.…”

Section: Discussionmentioning

confidence: 99%

“…Ostial stenoses are extremely rare since only five cases having undergone angioplasty are reported in the literature [3][4][5][6][7]. While angioplasty of distal anastomotic lesions provides good results in terms of restenosis and new revascularization of the target lesion, results on ostial lesions are not well known [8].…”

Section: Introductionmentioning

confidence: 99%

Percutaneous transluminal angioplasty of ostial lesions of internal mammary artery grafts

Jacq¹,

Lancelin²,

Brenot³

et al. 2001

Cathet Cardio Intervent

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The internal mammary artery (IMA) is currently the best graft for coronary bypass surgery and is therefore preferentially anastomosed to major arteries, usually the left anterior descending (LAD) artery. This graft may develop a stenosis, most often at the distal anastomosis. Ostial stenoses are rare and their pathophysiology uncertain. While angioplasty of distal anastomotic lesions provides adequate results, the very small number of published cases of angioplasty of ostial lesions explains the lack of knowledge on results of this type of procedure. The authors report six procedures of this type on five patients, including two with stenting. The primary success rate was 100%, with only one hospital complication in the form of pulmonary edema. Mean follow-up for 35 months revealed one sudden death due to probable restenosis, another death 3 years after angioplasty from rapid fatal shock without complementary investigation, and one case of unstable angina secondary to intrastent restenosis. These results suggest that this type of angioplasty is technically feasible with low risk, and that the restenosis rate seems relatively high, potentially presenting as sudden death, in the same way as unprotected dilatation of the native left main artery. A very close clinical follow-up of these patients is therefore necessary, with angiographic control in case of suspected ischemia.

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Unrecognized internal mammary artery stenosis treated by percutaneous angioplasty after coronary bypass surgery

Cited by 13 publications

References 9 publications

Initial and subsequent angiographic outcome of percutaneous transluminal angioplasty performed on internal mammary artery grafts.

Initial and subsequent angiographic outcome of percutaneous transluminal angioplasty performed on internal mammary artery grafts.

10-year results of coronary artery bypass grafting with microsurgical technique

Percutaneous transluminal angioplasty of ostial lesions of internal mammary artery grafts

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