Madhumanti Panja
Rabindranath Tagore International Institute of Cardiac Sciences (RTIICS), India
Title: Very late complication in drug induced and bare metal stents
Biography
Biography: Madhumanti Panja
Abstract
AIM: Coronary stents in PCI were designed to reduce abrupt vessel closure and restenosis. Despite pharmacological and technical advances, complication like; late thrombosis and restenosis are of concern for coronary revascularization procedure. The objective is to analyze the long-term follow-up information especially the late complication over several years in consecutive procedures.
Method & Results: A single center observational study was conducted from August 1996 to July 2004, in the department of Cardiology, IPGME&R, Kolkata, West Bengal, India. Till 2002 all had Bare Metal Stents (BMS) and then onwards majority (60%) underwent BMS and 40% were treated with Drug Eluting Stents (DES). A total of (* cases with first stent implantation and turned up for regular follow –up were included in this study. Over 15 years patients were strictly observed clinically 1, 2, 3 months initially and there after every 3 month or any time in between when symptoms experienced.
Mean age of the population was 55 + or – 2 years and 85% were male. Before the procedure, 34% had unstable angina. 28% had prior event of myocardial infraction and rest had chronic stable angina. Clinical profile showed diabetes mellitus in 1/3rd of the patients and 605 had hypertension. Majority (75%) revealed one vessel disease. Among 98 cases 80 had BMS and 18 had DES. During the follow-up (range 1 to 15 years), the incidence of major adverse cardiac event (MACE) in 12 cases with BMS and two with DES. Ten patient with BMS and two patient with DES had instent restenosis and late stent thrombosis in one with BMS and 2 with DES. Whereas coronary aneurysm was noted only in one patient with DES.
Conclusion: Bare metal stent is effective and safe. All complication except restenosis were higher in DES.