Percutaneous coronary revascularization in patients with formerly refractory angina pectoris in end-stage coronary artery disease – Not end-stage after allReportar como inadecuado




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BMC Cardiovascular Disorders

, 9:42

First Online: 28 August 2009Received: 02 April 2009Accepted: 28 August 2009DOI: 10.1186-1471-2261-9-42

Cite this article as: Jax, T.W., Peters, A.J., Khattab, A.A. et al. BMC Cardiovasc Disord 2009 9: 42. doi:10.1186-1471-2261-9-42

Abstract

BackgroundPatients with refractory angina pectoris in end-stage coronary artery disease represent a severe condition with a higher reduction of life-expectancy and quality of life as compared to patients with stable coronary artery disease. It was the purpose of this study to invasively re-evaluate highly symptomatic patients with formerly diagnosed refractory angina pectoris in end-stage coronary artery disease for feasible options of myocardial revascularization.

MethodsThirty-four Patients formerly characterized as having end stage coronary artery disease with refractory angina pectoris were retrospectively followed for coronary interventions.

ResultsOf those 34 patients 21 61.8% were eventually revascularized with percutaneous interventional revascularization PCI. Due to complex coronary morphology angulation, chronic total occlusion PCI demanded an above-average amount of time 66 ± 42 minutes, range 25–206 minutes and materials contrast media 247 ± 209 ml, range 50–750 ml; PCI guiding wires 2.0 ± 1.4, range 1–6 wires. Of PCI patients 7 33.3% showed a new lesion as a sign of progression of atherosclerosis. Clinical success rate with a reduction to angina class II or lower was 71.4% at 30 days. Surgery was performed in a total of8 23.5% patients with a clinical success rate of 62.5%. Based on an intention-to-treat 2 patients of originally 8 25% demonstrated clinical success. Mortality during follow-up 1–18 months was 4.8% in patients who underwent PCI, 25% in patients treated surgically and 25% in those only treated medically.

ConclusionThe majority of patients with end-stage coronary artery disease can be treated effectively with conventional invasive treatment modalities. Therefore even though it is challenging and demanding PCI should be considered as a first choice before experimental interventions are considered.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2261-9-42 contains supplementary material, which is available to authorized users.

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Autor: Thomas W Jax - Ansgar J Peters - Ahmed A Khattab - Matthias P Heintzen - Frank-Chris Schoebel

Fuente: https://link.springer.com/







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