ABSTRACT
BACKGROUND: This study will evaluate the difference between the frequency of restenosis in myocardial revascularization procedures by stents and CABG by coronarographic control after clinical criteria (angina). METHODS AND RESULTS: Out of the total of 6564 coronarographies performed (1999-2002) for diagnosis purposes, 3110 patients (44.8%) underwent myocardial revascularization procedures, PCI or CABG. PCI was performed in 981 patients (31%) and CABG in 1148 patients (37.3%). At the same time, we performed in our units 2067 surgical procedures, out of which 1148 (55%) revascularizations by CABG. The angiographic control for patients with myocardial revascularization by stent (55 patients) or CABG (50 patients) was performed by clinical criteria (angina reappears) on 105 patients. The restenosis we found in 47 patients (74.5%) treated by stent revascularization and in 29 patients from CABG procedures. In our study restenosis rate was 4.8% in patients with PCI and 2.5% in patients with CABG. CONCLUSIONS: Both surgical (CABG) and percutaneous coronary artery revascularization (PCI) have proved to be extremely effective in the treatment of patients with multivessel coronary disease. In our study restenosis rate was smaller in the patients with CABG than in the PCI group, taking into account the fact that we did not use drug eluting stent (DES) on a large scale. Results from the series of randomized trials (SOS, SIRIUS, ERACI, ARTS, BARI, etc.) have shown that the restenosis phenomenon is an apparent advantage in patients with DES. Restenosis prevention is a complex phenomenon (inflammation, procoagulation, cellular migration, etc.) and DES appearance opens a new era in PCI.
