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Disease Progression In The Target Vessels After Coronary Artery Bypass Using An In-situ Internal Thoracic Artery Based Composite Graft Versus Percutaneous Coronary Intervention
Min-Seok Kim1, Seong Wook Hwang
1, Ki-Bong Kim
1, Antonio M. Calafiore
2.
1Myongji Hospital, Go-yang-si, Korea, Republic of,
2Henry Dunant Hospital, Athens, Greece.
OBJECTIVE: When compared with a stent treatment, surgical revascularization using the left internal thoracic artery (ITA) showed a less progression of downstream coronary artery disease. The aim of the study was to compare disease progression in the downstream target vessels after coronary artery bypass using an in situ ITA-based composite graft versus percutaneous coronary intervention (PCI).
METHODS: Forty-six patients who underwent coronary artery bypass grafting (CABG) using an in-situ ITA based composite graft (N=19) or PCI (N=27) and who underwent 1-year follow-up angiography were included. Downstream target vessel disease progression was evaluated using the quantitative coronary angiography (QCA; Caas Workstation, Pie Medical Imaging, Netherland) preoperatively or at the time of PCI and at 1 year. The differences in QCA were compared between the 2 groups.
RESULTS: Preoperative characteristics were similar between the 2 groups. A total of 57 anastomoses were performed in 19 CABG patients, and 34 lesions were revascularized in 27 PCI patients. Follow-up coronary angiograms were performed at median 12.2 [11.9, 12.7] months. Changes in QCA were 7 [0, 21] in CABG patients and -12[-20, -5] in PCI patients, respectively (P<0.001).
CONCLUSIONS: Downstream target coronary vessel stenosis regressed after CABG and progressed after PCI 1-year after the procedures.
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