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Submitted: 26 June 2008
HERDIN Record #: PCHRD062808030609

Early clinical outcomes of patients with untreated versus treated compromised side branch (Stent jail) after coronary stent implantation of the parent vessel lesion .

Neil T. Gomez,
Frederick P. Vicente,
Ronaldo C. Manuel,
Rowena G. Cacas

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Background ÃÆ'Æ'Æ’ÃÆ'†â€™ÃÆ'Æ'â€Ã...¡ÃÆ'‚¢ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â‚¬Ã...¡ÃÆ'‚¬ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â€Ã...¡Ã‚¬ÃÆ'‚ Acute side branch (SB) compromise or occlusion (stent jail) after native coronary artery stenting is not infrequent and it comprises 6-41 percent. The purpose of this study is to determine the incidence of side branch compromised/ occlusion after coronary stent implantation of the parent vessel lesion and to determine the in-hospital and 3 months clinical outcomes (ischemic episodes, death, myocardial infarction and repeat revascularization rates) in patients with untreated versus treated compromised side branch after coronary stent implantation of the parent vessel lesion.

Method ÃÆ'Æ'Æ’ÃÆ'†â€™ÃÆ'Æ'â€Ã...¡ÃÆ'‚¢ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â‚¬Ã...¡ÃÆ'‚¬ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â€Ã...¡Ã‚¬ÃÆ'‚ This is a prospective cohort study. The correlation between the clinical outcomes were examined in 19 patients who was not treated and 18 patient who was treated with PTCA of the compromised side branch after coronary stenting of the parent vessel lesion.

Results ÃÆ'Æ'Æ’ÃÆ'†â€™ÃÆ'Æ'â€Ã...¡ÃÆ'‚¢ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â‚¬Ã...¡ÃÆ'‚¬ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â€Ã...¡Ã‚¬ÃÆ'‚ A total of 37 (8.26 percent) patients from a total of 448 patients who underwent coronary stenting from January 1, 2005 to November 31, 2005 at the Philippine Heart Center had compromised side branch after coronary stenting of the parent vessel lesion. Nineteen (51 percent) of these were not treated after coronary stenting of the parent vessel lesion and eighteen (49 percent) of these were treated by PTCA. In untreated group, 2 (9.5 percent) patients had episodes of chest pain during hospitalization and none (0%) from the treated group. It was also noted that the two patients who had episode of angina in the untreated group has a vessel sized of > 2 millimeter and the remaining 17 (89.5 percent) patients who had no chest pain has a vessel size of less than 2 millimeter. None suffered from reinfarction, repeat revascularization or death in both group during in-hospitalization. Three months follow up showed no episodes of angina, reinfarction, need for revascularization and death in both untreated and treated group.

Conclusion ÃÆ'Æ'Æ’ÃÆ'†â€™ÃÆ'Æ'â€Ã...¡ÃÆ'‚¢ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â‚¬Ã...¡ÃÆ'‚¬ÃÆ'Æ'Æ’ÃÆ'¢â‚¬Ã...¡ÃÆ'Æ'¢ÃÆ'¢â€Ã...¡Ã‚¬ÃÆ'‚ Compromised or occlusion of small side branches (< 2 millimeters) can be well tolerated even if it is left untreated. However occlusion or compromise of a large side branches (> 2 millimeters) should be treated even by PTCA alone to prevent the occurrence of acute clinical events. (Author)

Publication Type
Journal
Publication Sub Type
Journal Article, Original
Title
Philippine Heart Center Journal
Frequency
Quarterly
Publication Date
July-September 2006
Volume
12
Issue
3
Page(s)
9-11

Objectives

Primary Objective: To determine the incidence of side branch compromised/occlusion after coronary stent implantation of the parent vessel lesion.

Specific Objective: To determine the in hospital and three months clinical outcomes (death, myocardial infarction and repeat revascularization rates after 3 months in patients with untreated versus treated compromised side branch after coronary stent implantation of the parent vessel lesion.

LocationLocation CodeAvailable FormatAvailability
Philippine Council for Health Research and Development Library Abstract Print Format (Request Document)