Long-term outcomes of percutaneous revascularization for internal mammary artery–left anterior descending artery bypass failure

• Published in: Heart and vessels Vol. 38; no. 2; pp. 157 - 163
• Main Authors: Yamaguchi, Shogo, Uemura, Yusuke, Tanaka, Akihito, Takagi, Kensuke, Ohashi, Taiki, Tanaka, Miho, Umemoto, Norio, Yoshida, Ruka, Negishi, Yosuke, Iwama, Makoto, Takemoto, Kenji, Watarai, Masato, Kudo, Nobutaka, Morishima, Itsuro, Tatami, Yosuke, Takada, Yasunobu, Shimizu, Kiyokazu, Yoshida, Yukihiko, Tanaka, Toshikazu, Noda, Toshiyuki, Ishii, Hideki, Murohara, Toyoaki
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.02.2023; Springer Nature B.V
• Subjects: Aged; Biomedical Engineering and Bioengineering; Blood vessels; Cardiac Surgery; Cardiology; Clinical outcomes; Coronary Artery Bypass - adverse effects; Coronary Artery Bypass - methods; Coronary Vessels - surgery; Failure; Female; Grafting; Humans; Implants; Internal Mammary-Coronary Artery Anastomosis - adverse effects; Internal Mammary-Coronary Artery Anastomosis - methods; Lesions; Male; Mammary Arteries; Medicine; Medicine & Public Health; Middle Aged; Myocardial infarction; Myocardial Infarction - epidemiology; Original Article; Patients; Stents; Surgery; Surgical implants; Vascular Surgery; Vascular Surgical Procedures; Veins & arteries; Target lesion revascularization; Percutaneous revascularization; Internal mammary artery
• ISSN: 0910-8327; 1615-2573
• DOI: 10.1007/s00380-022-02150-8

Despite the excellent long-term results of internal mammary artery (IMA)–left anterior descending (LAD) bypass, percutaneous revascularization of IMA is sometimes required for IMA-LAD bypass failure. However, its clinical outcomes have not been fully elucidated. The aim of this study was to investigate the long-term clinical outcomes, including target lesion revascularization (TLR) following contemporary percutaneous revascularization of failed IMA bypass graft. We examined data of 59 patients who had undergone percutaneous revascularization of IMA due to IMA-LAD bypass failure at nine hospitals. Patients with IMA graft used for Y-composite graft or sequential bypass graft were excluded. The incidence of TLR was primarily examined, whereas other clinical outcomes including cardiac death, myocardial infarction, and target vessel revascularization were also evaluated. Mean age of the enrolled patients was 67.4 ± 11.3 years, and 74.6% were men. Forty patients (67.8%) had anastomotic lesions, and 17 (28.8%) underwent revascularization within three months after bypass surgery. Procedural success was achieved in 55 (93.2%) patients. Stent implantation was performed in 13 patients (22.0%). During a median follow-up of 1401 days (interquartile range, 282–2521 days), TLR was required in six patients (8.5% at 1, 3, and 5 years). Patients who underwent percutaneous revascularization within 3 months after surgery tended to have a higher incidence of TLR. Clinical outcomes of IMA revascularization for IMA-LAD bypass failure were acceptable.