Pulmonary vein stenosis or occlusion after catheter ablation of atrial fibrillation: long-term comparison of drug-eluting versus large bare metal stents

Pulmonary vein stenosis or occlusion (PVS/O) following catheter ablation of atrial fibrillation is a rare but potentially severe complication. Treatment options include angioplasty with or without stent implantation, but data on outcome and optimal treatment strategy are limited. We report long-term results after catheter-based treatment of patients with symptomatic PVS/O. Retrospective analysis was performed in patients undergoing pulmonary vein (PV) angiography for suspected PVS/O. All patients with PVS/O were treated with balloon angioplasty and implantation of a coronary drug-eluting stent (DES) or a peripheral large-diameter bare metal stent (LD-BMS). A total of 25 high-degree PVS/Os in 19 patients were treated. Nine PVs were treated with angioplasty and DES implantation and 16 with angioplasty and LD-BMS implantation. The ostial PV diameter was not different in the DES and LD-BMS groups (10.2 ± 2.5 mm vs. 11.1 ± 1.9 mm, P = 0.34), but the PV/stent diameter ratio was significantly lower in the former (0.43 ± 0.13 vs. 0.82 ± 0.13, P