Interventional treatment of coronary bypass stenosis: comparison of intracoronary stent implantation and balloon angioplasty

Background and objective: Balloon angioplasty of a stenosed bypass graft ha s a much higher risk of recurrent stenosis than dilatation of a stenosed na tive coronary artery. Intracoronary stent implantation has established itse lf as the better treatment of native coronary artery stenosis than conventi onal balloon angioplasty. However, there is still uncertainty whether intra coronary stent implantation in stenosed bypass vessels gives better long-te rm results than conventional balloon angioplasty. Patients and methods: Results were retrospectively analysed of unrandomized 224 primarily successful interventions - 122 balloon dilatations and 102 s tent implantations - performed between January 1996 and June 1998 on stenos ed coronary bypass grafts, re-examined by coronary angiography an average o f 6 months later. All but 11 patients were on combined aspirin and ticlopid ine antiplatelet aggregation treatment. Results: There was a significantly lower 6-month restenosis rate (30.4%) af ter stent implantation than after balloon dilatation (51.6%). The re-interv ention Fate was also significantly lower after stent implantation. Conclusion: These data suggest that stent implantation of stenosed coronary bypass grafts under cover of platelet-aggregation inhibition with aspirin and ticlopidine provides a lower restenosis and thus higher revascularizati on rate than conventional balloon dilatation.