Alexandre Schaan de Quadros et al. Carlos A. M. Gottschall Rogério Sarmento-Leite Lenise Valler André Bussmann
OBJECTIVE: To assess the influence of uncomplicated coronary dissections in the incidence of target vessel revascularization and cardiovascular events after 1 year. METHODS: Patients treated from June 1996 to December 2000, with data prospectively collected and uncomplicated dissections (G1, n=36), were compared with those patients without dissections (G2, n=871). Data were assessed with SPSS 8.0 statistical software, the outcomes were compared with the Kaplan-Meier curve, and the significance level was assessed using the log-rank test. RESULTS: Clinical features were similar in both groups: G1 had lower mean reference diameters (P<0.0001), a greater number of patients with type C lesions (P=0.01), a lower final lumen diameter at the end of the procedure (P=0.003), and a greater balloon/artery ratio (P<0.0001). In the multivariate analysis, only the reference diameter and the artery/balloon ratio were independently associated with the presence of residual dissections. No statistically significant difference existed in the incidence of revascularization of the target vessel and major cardiovascular events, at 1-year clinical follow-up, between the 2 groups of patients. Predictors of adverse clinical events at 1 year were the reference diameter, lesion extension, and residual stenosis, rather than the presence of residual dissection. CONCLUSION: Uncomplicated residual dissections after coronary stents are associated with narrower vessels and a higher balloon/artery ratio. Residual dissections are not associated with worse outcomes at 1-year clinical follow-up.
