Percutaneous revascularization of the internal mammary artery graft: Short- and long-term outcomes

OBJECTIVES We evaluated the short- and long-term clinical outcomes after pe rcutaneous revascularization of the internal mammary artery (IMA) graft. BACKGROUND Previous reports in a relatively small number of patients have i ndicated the safety of balloon angioplasty for the treatment of stenoses in the IMA graft. However, the use of alternative interventional techniques a nd their long-term results have not yet been evaluated. METHODS We analyzed the in-hospital and one-year clinical outcomes of 174 c onsecutive patients who underwent percutaneous revascularization of 202 les ions located in the IMA graft, by either balloon angioplasty or stenting RESULTS Anastomotic lesions were evident in 128 cases (63%), and they were more commonly treated with balloon angioplasty (116/128, 91%), whereas lesi ons located at the ostium (n = 16, 8%) were more frequently treated with st ents (11/16, 69%). Procedural success was 97% with excellent in-hospital ou tcome: 0.6% mortality rate, no Q-wave myocardial infarction (MI) and 0.6% r ate of urgent bypass surgery. Cumulative one-year rates were: mortality 4.4 %, MI 2.9% and target lesion revascularization (TLR) 7.4%. CONCLUSIONS Revascularization of the IMA graft can be performed safely, wit h high procedural success and a low rate of in-hospital complications. Long -term follow-up showed very low TLR rate. (C) 2000 by the American College of Cardiology.