Publication Sub Type
Journal Article, Original
Philippine Heart Center Journal
Background: Acute side branch (SB) compromise or occlusion (stent jail) after native coronary artery stenting is not infrequent and it compromises 6-41%. The purpose of this study is to determine the incidence of side branch compromised/ occlusion after coronary stent implantation of the parent vessel lesion and to determine the in-hospital and 3 months clinical outcomes (ischemic episodes, death, myocardial infarction and repeat revascularization rates) in patients with untreated versus treated compromised side branch after coronary stent implantation of the parent vessel lesion.
Method: This is a prospective cohort study. The correlation between the clinical outcomes were examined in 19 patients who was not treated and 18 patient who was treated with PTCA of the compromised side branch after coronary stenting of the parent vessel lesion.
Results: A total of 37 (8.26%) patients from a total of 448 patients who underwent coronary stenting from January 1, 2005 to November 31, 2005 at the Philippine Heart Center had compromised side branch after stenting of the parent vessel lesion. Nineteen (51%) of these were not treated after coronary stenting of the parent vessel lesion and eighteen (49%) of these were treated by PTCA. In untreated group, 2 (9.5%) patients had episodes of chest pain during hospitalization and none (0%) from the treated group. It was also noted that the two patients who had episode of angina in the untreaded group has a vessel size of >2 millimeter and the remaining 17 (89.5%) patients who had no chest pain has a vessel size of less than 2 millimeter. None suffered from reinfarction, repeat revascularization or death on both group during in-hospitalization. Three months followed up showed no episodes of angina, reinfarction, need for ravscularization and death in both untreated and treated group.
Conclusion: Compromised or occlusion of small side branches (< 2 millimeters) can be well tolerated even if it is left untreated. However occlusion or compromise of a lage side branc (>2 millimeters) should be treated even by PTCA alone to prevent the occurence of acute clinical events.