Off-pump coronary endarterectomy with stent removal for in-stent restenosis in the left anterior descending artery
Bibliographic record
Abstract
OBJECTIVES: In-stent restenosis (ISR) remains a major complication of percutaneous coronary intervention, even in the current era of drug-eluting stents (DESs). We reviewed the clinical and angiographic outcomes of coronary endarterectomy with stent removal using an off-pump technique in patients with ISR in the left anterior descending artery (LAD). METHODS: Twelve patients with long-segment ISR in the LAD underwent off-pump coronary artery bypass grafting with coronary endarterectomy and stent removal at our institution from November 2005 to August 2012. Their mean age was 65.0 ± 6.3 years, and 11 were male. DESs were used in 10 patients and bare-metal stents were used in the remaining 2 patients. The interval from the latest intervention ranged from 4 to 102 months (median, 12 months). RESULTS: None of the procedures were converted to on-pump surgery, and there were no operative deaths. The left internal thoracic artery (LITA) was used to reconstruct the endarterectomized LAD in all patients, and the mean length of the arteriotomy in the LAD was 5.3 ± 1.0 cm. The LITA and LAD were patent in all patients on both early postoperative and follow-up angiography. At the median 24-month follow-up (range, 12-78 months), there were no late deaths and all patients were at a Canadian Cardiovascular Society class of 0 or I. CONCLUSIONS: Coronary endarterectomy with stent removal can be safely performed using an off-pump technique and provides favourable clinical and angiographic outcomes in patients with long-segment ISR in the LAD.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".