Stent-grafts versus drug-eluting stents in arterial aneurysms, insights from the International Coronary Artery Aneurysm Registry (CAAR)

• Published in: REC, Interventional cardiology (Internet. English ed.) Vol. 4; no. 2; pp. 107 - 114
• Main Authors: Núñez-Gil, Iván J., Cerrato, Enrico, Bollati, Mario, Nombela-Franco, Luis, Terol, Belén, Alfonso-Rodríguez, Emilio, Camacho-Freire, Santiago J., A. Villablanca, Pedro, Amat Santos, Ignacio J., Torre-Hernández, José M. de la, Pascual, Isaac, Liebetrau, Christoph, Camacho, Benjamín, Pavani, Marco, Adriano Latini, Roberto, Varbella, Ferdinando, Jiménez Díaz, Víctor Alfonso, Piraino, Davide, Mancone, Massimo, Alfonso, Fernando, Antonio Linares, José, Jiménez-Mazuecos, Jesús M., Palazuelos-Molinero, Jorge, Lozano, and, Íñigo, Fernández-Ortiz, Antonio, registry investigators, on behalf of the CAAR
• Format: Journal Article
• Language: English
• Published: Permanyer 01-04-2022
• Subjects: Angioplasty; Coronary aneurysm; Registry; Stent; Stent graft
• ISSN: 2604-7322; 2604-7322
• DOI: 10.24875/RECICE.M21000241

ABSTRACT Introduction and objectives: Coronary artery aneurysms are a complex situation. Our main objective is to describe the frequency of use of covered stents (grafts) for their management, as well as to characterize their long-term results compared to drug-eluting stents. Methods: Ambispective observational study with data from the International Coronary Artery Aneurysm Registry (CAAR) (NCT-02563626). Only patients who received a stent-graft or a drug-eluting stent where the aneurysm occurred were selected. Results: A total of 17 patients received, at least, 1 stent-graft while 196 received 1 drug-eluting in the aneurysmal vessel. Male predominance, a higher rate of dyslipidemia, a past medical history of coronary artery disease, previously revascularized coronary artery disease, and giant aneurysms were reported in the stent-graft cohort. The independent predictive variables of the composite endpoint of all-cause mortality, heart failure, unstable angina, reinfarction, stroke, systemic embolism, bleeding or any aneurysmal complications at the median follow-up of 38 months were suggestive of the existence of connective tissue diseases (HR, 5.94; 95%CI, 1.82-19.37), left ventricular dysfunction ≤ 55% (HR, 1.84; 95%CI, 1.09-3.1), and an acute indication for heart catheterization (HR, 2.98; 95%CI, 1.39-6.3). The use of stent-grafts was not associated with the occurrence of more composite endpoints (23.5% vs 29.6%; P = .598). Conclusions: The use of stent-grafts to treat coronary aneurysms is feasible and safe in the long-term. Randomized clinical trials are needed to decide what the best treatment is for these complex lesions. Keywords: Coronary aneurysm. Registry. Stent. Stent graft. Angioplasty.