Rev. Bras. Cardiol. Invasiva.2017;25(1-4):22-6.

Percutaneous coronary intervention in small-caliber arteries

Felipe de Macedo Coelho, Apoana Gomes Flori, Marco Tulio de Souza, Vladimir Ailton Cuma Nancassa, Flavius Augustus Magliano, Jorge Luis Vivar Sanches, Sidney Ramos Borges Filho, Erlon Oliveira de Abreu Silva, Rosley Weber Alvarenga Fernandes

DOI: 10.31160/JOTCI2017;25(1-4)A0006

ABSTRACT

Background:

Percutaneous coronary intervention (PCI) in small-caliber arteries corresponds to 30 to 40% of invasive therapeutic procedures and shows high and persistent rates of restenosis, despite the evolution of the devices used. The objective of this study was to evaluate changes in patient outcomes associated with the evolution of this therapeutic modality in Brazil during the last 10 years.

Methods:

A total of 24,895 patients from the National Center for Cardiovascular Interventions (CENIC) registry were included. These patients were subjected to 25,892 procedures with at least one stent with a diameter ≤ 2.5 mm between 2006 and 2016, which was subdivided into three periods: 2006-2008, 2009-2011 and 2012-2016. The clinical, angiographic and in-hospital outcomes of these patients were evaluated.

Results:

The mean age was 63.3 years. There was a predominance of male patients (59.7%), 26.1% had diabetes, and 59.7% had single-vessel coronary artery disease. The mean diameter of the stents used was 2.47 mm, and 25.5% were drug-eluting stents. Among the in-hospital outcomes, 140 deaths (0.6%), 79 myocardial infarctions (0.3%) and four emergency myocardial revascularization surgeries (0.02%) occurred. The prevalence of cardiovascular risk factors and the rate of serious adverse cardiac events decreased (1.2% vs. 0.6%; p < 0.0001) from the 2006-2008 to the 2012-2016 period.

Conclusions:

In patients undergoing percutaneous coronary intervention in small-caliber vessels registered in the CENIC, there was a favorable temporal evolution related to a decrease in risk factors and a lower rate of in-hospital complications, despite an increase in the complexity of the procedures.

Percutaneous coronary intervention in small-caliber arteries

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