Document Detail

Percutaneous transluminal angioplasty of ostial lesions of internal mammary artery grafts.
MedLine Citation:
PMID:  11246255     Owner:  NLM     Status:  MEDLINE    
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.
L Jacq; B Lancelin; P Brenot; C Caussin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  52     ISSN:  1522-1946     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2001 Mar 
Date Detail:
Created Date:  2001-03-14     Completed Date:  2001-06-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  368-72     Citation Subset:  IM    
Department of Interventional Cardiology, CC Marie Lannelongue, Le Plessis Robinson, France.
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MeSH Terms
Angina, Unstable / radiography,  therapy*
Angioplasty, Transluminal, Percutaneous Coronary*
Coronary Angiography
Coronary Disease / radiography,  therapy*
Graft Occlusion, Vascular / radiography,  therapy*
Internal Mammary-Coronary Artery Anastomosis*
Middle Aged

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