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Ann Thorac Surg 1995;60:65-66
© 1995 The Society of Thoracic Surgeons

Discussion

The first 20% of the full text of this article appears below.

	Introduction

 
See also page 60.

DR CARY W. AKINS (Boston, MA): Doctor Craver and colleagues at Emory are to be congratulated for once again bringing cardiac surgeons up to date on the surgery for complications of newer techniques of invasive cardiology, in this case, the intracoronary stent. I also thank Dr Craver for supplying me with a copy of the manuscript before the meeting. The presentation describes excellent operative and long-term survival after coronary grafting for failed stent procedures between 1987 and 1994 in 68 patients, of whom 53 required emergency grafting.

The intracoronary stent may be the first adjunct to angioplasty that actually decreases the incidence of restenosis as seen in the documented results of the Stress Stent Trial in which restenosis fell from about 40% to about 30%. These results have led to an increasing utilization of stents for broader applications in many centers, and thus the current report is very timely. I have several questions for Dr Craver.

You noted that 56 of the 68 patients received a Gianturco-Roubin stent. At Massachusetts General Hospital, our interventional cardiology group, led by Drs Palacios, Gold, and Leinbach, has documented a requirement for very high levels of anticoagulation with that particular stent; they tried to . . . [Full Text of this Article]

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