CABG in Patients with Intracoronary Stents

Hüsnü SEZER, Ahmet KUZGUN, Sırrı AKEL, Cüneyd ÖZTÜRK, Sibel KUZUCAN, Selma SEZER

Kalp ve Damar Cerrahisi Kliniği, International Hospital/İstanbul

Coronary stenting has become an established treatment for suboptimal results or acute occlusion after conventional angioplasty, and it reduced restenosis rates in comparision with PTCA. The use of intracoronary stents in an increasing number of patients have brought with them several severe complications; acute and subacute stent thrombosis, stent embolization, stent malpositioning and arterial perforation. On the other hand restenosis were seen after elective stenting in the course of time.

Seventeen cases which were stented, underwent CABG between September 1996 and September 1998. Twelve patients were operated electively because of restenosis. All these patients had LAD obstruction. Aproximately, the time between stenting and operation was 9.5 months (1 week - 2 years). Two patients with acute occlusion, two patients with entrapped guide-wire, and one patient with undeployed stent in LMCA were operated emergently. In four cases multipl stents cause limitation grafting site of the vessels so, anastomoses were performed in distal bed. Two patients died at early post-operative period. In follow-up period ranging from 2-20 months (10±4.5) all the patients were in NYHA class I or II.

Stent restenosis or acute occlusion after stenting can be treated by CABG. Nevertheles, surgical risk became increased after acute occlusion. Multipl stenting which causes limitation of grafting site, and extraction of stent or not, must be discussed.

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