A 65-year-old man who had previously undergone multiple stenting on the coronary tree, was referred for urgent surgery. The left anterior descending coronary artery was found to be completely stented from the proximal to the distal portion. Open endarterectomy was required for removal of multiple thrombosed stents and reconstruction of the left anterior descending artery using left internal mammary artery. This highlights the need to spare the distal parts of coronary vessels for future surgery.
SoS Investigators. Coronary artery bypass surgery versus percutaneous coronary intervention with stent implantation in patients with multivessel coronary artery disease (the Stent or Surgery trial): a randomised controlled trial. Lancet2002;360(9338):965–70.
2.
TaggartDPThomasB. Ferguson Lecture. Coronary artery bypass grafting is still the best treatment for multivessel and left main disease, but patients need to know. Ann Thorac Surg2006;82:1966–75.
3.
PfistererMBrunner-La RoccaHPBuserPTRickenbacherPHunzikerPMuellerC. Late clinical events after clopidogrel discontinuation may limit the benefit of drug-eluting stents: an observational study of drug-eluting vs. bare metal stents. J Am Coll Cardiol2006;48:2584–91.
4.
ShuchmanM. Trading restenosis for thrombosis? New questions about drug-eluting stents. New Engl J Med2006;355;19:1949–52.
5.
The task force for percutaneous coronary intervention of the European Society of Cardiology. Guidelines for percutaneous coronary interventions. Eur Heart J2005;26:804–47.
6.
KappeteinAPDawkinsKDMohrFWMackMJRussellMEPomarJ. Current percutaneous coronary intervention and coronary artery bypass grafting practices for three-vessel and left main coronary artery disease. Insights from the SYNTAX run-in phase. Eur J Cardiovasc Surg2006;29:486–91.
