Effects of stenting of recent or chronic coronary occlusions on late vessel patency and left ventricular function

Am J Cardiol. 1997 Nov 1;80(9):1150-4. doi: 10.1016/s0002-9149(97)00631-0.

Abstract

Due to high rates of late vessel reocclusion, balloon angioplasty of recent or chronic coronary occlusions is not associated with a sustained improvement in left ventricular function. Recent studies have suggested that stent implantation at coronary occlusions significantly reduces late vessel occlusion. We thus designed a study to analyze the effect of stent implantation at coronary occlusions on late vessel potency and left ventricular function. Twenty-four consecutive patients with recent or chronic coronary occlusions had successful stent implantation and were enrolled in a 6-month angiographic follow-up program. Contrast left ventricular cineangiography, at baseline and 6-month follow-up, as well as preprocedural, postprocedural, and follow-up angiograms analyzed with quantitative angiography were available in 22 of the patients (92%). At follow-up, no vessel reocclusion was observed and 32% of the patients, as analyzed by the >50% diameter stenosis criterion, had restenosis. There was a significant improvement in global left ventricular function with a decrease in both left ventricular end-diastolic volume index (LVEDVI, p <0.01) and left ventricular end-systolic volume index (LVESVI, p <0.0001) and an increase in left ventricular ejection fraction (LVEF, p <0.0001). Similarly, regional wall motion in the territory of the recanalized artery was also significantly improved (p <0.05). These effects were associated with a reduction in left ventricular filling pressure (p <0.0001). Stent implantation following balloon angioplasty of recent or chronic coronary occlusion is associated with a low rate of late vessel reocclusion, a reduction in cardiac volume, and an increase in ejection fraction. Such effects on left ventricular volumes could have a significant impact on patient survival.

MeSH terms

  • Angioplasty, Balloon, Coronary*
  • Cineangiography
  • Coronary Angiography
  • Coronary Disease / diagnostic imaging
  • Coronary Disease / epidemiology
  • Coronary Disease / physiopathology
  • Coronary Disease / therapy*
  • Coronary Vessels / physiopathology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Recurrence
  • Stents*
  • Time Factors
  • Treatment Outcome
  • Vascular Patency / physiology
  • Ventricular Function, Left / physiology*