17684
document
Retroinfusion-supported stenting in high-risk patients for percutaneous intervention and bypass surgery : results of the prospective randomized myoprotect I study . The objective of this study was to assess event-free survival and total treatment costs of retroinfusion-supported stenting in high-risk patients compared to bypass surgery . An increasing number of patients with main-stem and main-stem-equivalent stenosis are treated by stent implantation , which appears to be safe in the short-term follow-up . However , there is a lack of randomized studies comparing conventional bypass surgery with stent implantation , particularly in patients with high risk for both treatments . We here report on the 1-year results of a prospective randomized single-center study in patients with symptomatic main-stem and main-stem-equivalent lesions with substantially increased risk for bypass surgery . Patients where randomized to undergo either percutaneous transluminal coronary angioplasty/stent procedure ( n = 23 ) or bypass surgery ( n = 21 ) . Patients randomized to stent implantation were supported by selective pressure-regulated retroinfusion of the anterior cardiac vein during ischemia . Patients of the stent group and the bypass group did not differ in baseline characteristics , including Parsonnet score and quality-of-life score . Twenty-eight-day mortality and 1-year mortality rate as well as quality-of-life scores were similar in both groups . Event-free survival after 1 year was higher in the bypass group ( 71.4 % vs. 52.3 % ; P = 0.02 ) due to a lower target lesion revascularization rate . With regard to total treatment costs , however , the stent group compared favorably to the bypass group ( 9,346 +/- 807 vs. 26,874 +/- 3,985 euro ) , predominantly as a result of a shorter intensive care and hospital stay . In this first randomized study in high-risk patients for stent implantation and bypass surgery , patients with retroinfusion-supported stent implantation had a similar 1-year outcome and quality of life compared to patients with bypass surgery . Though in the stent group event-free survival was lower and target lesion revascularization rate was higher , retroinfusion-supported stent implantation was associated with substantially lower costs and might be considered as an alternative treatment option in this selected group of high-risk patients .
17685
Intervention_Surgical
Retroinfusion-supported stenting
17686
Intervention_Surgical
bypass surgery
17687
Intervention_Surgical
retroinfusion-supported stenting
17688
Intervention_Surgical
bypass surgery
17689
Intervention_Surgical
stent implantation
17690
Intervention_Surgical
conventional bypass surgery
17691
Intervention_Surgical
stent implantation
17692
Intervention_Surgical
percutaneous transluminal coronary angioplasty/stent procedure
17693
Intervention_Surgical
bypass surgery
17694
Intervention_Surgical
stent implantation
17695
Intervention_Surgical
selective pressure-regulated retroinfusion
17696
Intervention_Surgical
stent
17697
Intervention_Control
bypass
17698
Intervention_Surgical
stent implantation
17699
Intervention_Surgical
bypass surgery
17700
Intervention_Surgical
retroinfusion-supported stent implantation
17701
Intervention_Surgical
bypass surgery
17702
Intervention_Surgical
retroinfusion-supported stent implantation
17703
Outcome_Mortality
event-free survival
17704
Outcome_Other
total treatment costs
17705
Outcome_Other
Parsonnet score
17706
Outcome_Other
quality-of-life score
17707
Outcome_Mortality
Twenty-eight-day mortality
17708
Outcome_Mortality
1-year mortality rate
17709
Outcome_Other
quality-of-life scores
17710
Outcome_Mortality
Event-free survival
17711
Outcome_Other
total treatment costs
17712
Outcome_Other
1-year outcome
17713
Outcome_Other
quality of life
17714
Outcome_Mortality
event-free survival
17715
Outcome_Physical
revascularization rate
17716
Outcome_Other
lower costs
17717
Participant_Condition
high-risk
17718
Participant_Condition
percutaneous intervention
17719
Participant_Condition
bypass surgery
17720
Participant_Condition
high-risk patients
17721
Participant_Condition
main-stem and main-stem-equivalent stenosis
17722
Participant_Condition
patients with high risk
17723
Participant_Sample-size
23
17724
Participant_Sample-size
21
17725
Participant_Condition
stent group
17726
Participant_Condition
bypass group
17727
Participant_Condition
high-risk patients for stent implantation
17728
Participant_Condition
bypass surgery