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Heart Surg Forum. 2004;7(5):E490-2.

Revascularization of the left anterior descending artery with drug-eluting stents: comparison with arterial off-pump surgery.

Author information

  • 1Department of Cardiology, The Tel Aviv Sourasky Medical Center and The Sackler Faculty of Medicine, Tel Aviv University, Israel. isach@tasmc.health.gov.il

Abstract

BACKGROUND:

This study compared early results of left anterior descending artery (LAD) stenting using drug-eluting stents (Cypher) with off-pump bilateral internal thoracic arterial (BITA) grafting.

METHODS:

From June 2002 to June 2003, 200 consecutive patients underwent myocardial revascularization of the LAD territory, 100 by Cypher and 100 by BITA. The 2 groups were similar; however, left main disease and triple-vessel disease (20% and 75% versus 2% and 28%), age >70 (36% versus 17%) and intraaortic balloon pump (7% versus 0%) were more prevalent in the BITA group, and prior percutaneous coronary angiogplasty to the LAD was more prevalent in the Cypher group (28% versus 16%).

RESULTS:

The number of coronary vessels treated per patient in the BITA group was higher (2.7 versus 1.45, P < .01). Thirty-day mortality was 1% in the BITA group and 0% in the Cypher group. Mean follow-up was 12 months. There was 1 late death in each group. Angina returned in 32% of the Cypher group and in 1% of the BITA group. There were 9 reinterventions in the Cypher group: 7 coronary angioplasties (including 2 to the LAD) and 2 surgical interventions. There was neither recurrent angina nor reintervention in the surgical group.

CONCLUSIONS:

Despite a higher risk profile of patients treated with BITA, their clinical outcome is better. A longer and more complete angiographic follow-up is required to determine the role of drug-eluting stents in LAD revascularization.

[PubMed - indexed for MEDLINE]
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