Coronary stenting in cardiac allograft vasculopathy

Jain, S. P., Ramee, S. R., White, C. J., Ventura, H. O., Zhang, S. Y., Jenkins, J. S. and Collins, T.J. (1998) Coronary stenting in cardiac allograft vasculopathy. Journal of the American College of Cardiology, 32 6: 1636-1640. doi:10.1016/S0735-1097(98)00432-X

Author Jain, S. P.
Ramee, S. R.
White, C. J.
Ventura, H. O.
Zhang, S. Y.
Jenkins, J. S.
Collins, T.J.
Title Coronary stenting in cardiac allograft vasculopathy
Journal name Journal of the American College of Cardiology   Check publisher's open access policy
ISSN 0735-1097
Publication date 1998-11
Sub-type Article (original research)
DOI 10.1016/S0735-1097(98)00432-X
Volume 32
Issue 6
Start page 1636
End page 1640
Total pages 5
Place of publication San Diego, CA, United States
Publisher Elsevier
Language eng
Formatted abstract
Objective. The purpose of this study was to evaluate acute angiographic success, in-hospital complications and long-term outcome after intracoronary stenting in patients with cardiac allograft vasculopathy.
Background. The application of conventional interventional modalities to treat discrete lesions in patients with cardiac allograft vasculopathy is associated with higher procedural morbidity, mortality and higher restenosis compared to atherosclerotic coronary artery disease. Elective coronary stenting has been shown to lower restenosis rates and improve long-term outcome in selected patients with native coronary artery disease; however, its safety and efficacy in reducing restenosis in patients with cardiac allograft vasculopathy is unknown.
Methods. Ten patients with 19 discrete lesions in a major coronary artery without diffuse distal disease underwent intracoronary stenting using Palmaz-Schatz stents. The average stent size was 3.4 mm, and the stent/artery ratio was 0.99 ± 0.07. Eight of ten (80%) patients received antiplatelet therapy (aspirin plus ticlopidine) only.
Results. Procedural success was 100% with no in-hospital stent thrombosis, Q-wave myocardial infarction or death. Minimal luminal diameter increased from 0.83 ± 0.38 mm to 3.23 ± 0.49 mm after stenting. Diameter stenosis decreased from 74.91 ± 11.52% to 5.90 ± 4.09% after stenting. Follow-up angiography was performed in 8 of 10 (80%) patients and 16 of 19 (84%) lesions. Target lesion revascularization was required in 2 of 10 (20%) patients and 3 of 16 (19%) lesions. Allograft survival was 7 of 10 (70%) at the end of 22 ± 11 months follow-up.
Conclusions. Intracoronary stenting can be performed safely with excellent angiographic success in selected patients with cardiac allograft vasculopathy. The restenosis rate appears to be low despite the aggressive nature of the disease. A multicenter study with a larger number of patients is required to assess its efficacy in reducing restenosis and improving allograft survival.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Created: Mon, 14 Mar 2011, 10:09:12 EST