Abstract:

Percutaneous coronary intervention is a method of choice in patients with recurrence of angina after aorto-coronary bypass. Endovascular interventions after aorto-coronary bypass are associated with a high risk of distal embolism and technical difficulties. On the other hand, revascularization of native coronary arteries in patients after aorto-coronary bypass, leads to worse results than PCI in patients without prior cardiac operations.

Aim: was to compare results of stenting of coronary bypass graft and native artery stenting in patients with recurrence of angina after aorto-coronary bypass, with use of proposed algorithm.

Materials and methods: for the period 2010-2014, in 3rd Central Military Clinical Hospital named after A.A.Vishnevsky of Ministry of Military Defence, 168 patients with coronary bypass defeat underwent operation: in 80 patients native artery reconstruction and in 88 - aorto-coronary bypass graft stenting were performed.

Due to impossible endovascular revascularization, 14 patients underwent repeated aorto-coronary bypass; after that they were excluded from research.

Included into research patietns were treated by different stents: drug-eluting stents (DES), bare metal stents (BMS) and combination BMS+DES. In first group the rate of DES implantation was higher (60% vs 37,5%); in the second group stent placement was comparable (DES 46,6% vs BMS 50%).

The results of this study show that the choice of revascularization strategy according to the presented algorithm, the short-term outcomes of both tactics are comparable.  

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