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Safety of aortic aneurysm repair 8 weeks after percutaneous coronary intervention for coronary artery disease: a cohort study

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العنوان: Safety of aortic aneurysm repair 8 weeks after percutaneous coronary intervention for coronary artery disease: a cohort study
المؤلفون: Mannacio, Vito A., Mannacio, Luigi, Monaco, Mario, Antignano, Anita, Giordano, Raffaele, Pinna, Giovanni B., Musumeci, Antonino, Iannelli, Gabriele
المصدر: Updates in Surgery; 20240101, Issue: Preprints p1-9, 9p
مستخلص: Guidelines advice against dual antiplatelet therapy (DAPT) discontinuation less than 12 months after percutaneous coronary intervention with drug-eluting stents (DES-PCI). However, any delay of necessary surgery in patients with descending thoracic (DTA) or abdominal aortic aneurysm (AAA), treated by DES-PCI, increases the risk of aneurysm rupture/dissection. We evaluated the safety of 8-week waiting time between DES-PCI and endovascular aortic repair (EVAR). 1152 consecutive patients with coronary artery disease (CAD) needing elective DTA or AAA repair were enrolled and divided into two groups. Group A included 830 patients treated by DES-PCI for significant CAD who underwent surgery 8 weeks after implantation. Group B included 322 patients treated by DES-PCI at least 6 months before with no residual significant CAD and treated by elective EVAR. Groups were compared according to a composite of death, myocardial infarction, stent thrombosis, cerebrovascular events and bleeding. No aneurysm rupture/dissection occurred while waiting for surgery. Hospital averse events occurred in 6.2% (52/830) group A patients versus 6.5% (21/322) group B patients (p= 0.8). Mortality was 0.7% (6/830) in group A and 0.9% (3/322) in group B (p= 0.7). Multivariate predictors of events were triple vessel DES-PCI (p< 0.001), > 3 stents implanted (p< 0.001), early-generation stents (p< 0.001), diabetes insulin requiring (p= 0.01), stent diameter < 3.0 mm (p= 0.009) and total stented length > 30 mm (p= 0.02). Eight weeks of waiting after DES-PCI in addition to an adequate management of DAPT were safe in terms of cardiac morbidity and bleeding complications. No aneurysm rupture occurred in the interval before surgery.
قاعدة البيانات: Supplemental Index
الوصف
تدمد:2038131X
20383312
DOI:10.1007/s13304-020-00729-2