Document Detail

Clinical significance of distal embolization after transluminal extraction atherectomy in diffusely diseased saphenous vein grafts.
MedLine Citation:
PMID:  8197974     Owner:  NLM     Status:  MEDLINE    
Standard balloon angioplasty of degenerated saphenous vein graft lesions may be complicated by distal embolization, particularly in the presence of intragraft thrombus. Transluminal extraction atherectomy may be useful in this setting because of its ability to remove particulate debris. This study was designed to identify the incidence and prognostic significance of distal embolization after transluminal extraction atherectomy in high-risk saphenous vein graft lesions. To address these issues the clinical course of 65 consecutive patients (86 high-risk saphenous vein graft lesions) was reviewed after extraction atherectomy. Distal embolization occurred in 11 (12.8%) of 86 high-risk lesions. The majority (63.6%) of these episodes occurred after adjunct balloon dilatation following uncomplicated use of the extraction atherectomy catheter. Correlates of distal embolization included patient age and the presence of intragraft thrombus. Major in-hospital complications developed more often in patients with distal embolization (46% vs 2% in those without distal embolization, p < 0.001), resulting in a reduced procedural success rate in this group (55% vs 91%, p = 0.01). We conclude that the risk of distal embolization after saphenous vein graft angioplasty, although potentially reduced, is not eliminated with transluminal extraction atherectomy, particularly in lesions with superimposed thrombus.
M K Hong; J J Popma; A D Pichard; K M Kent; L F Satler; Y C Chuang; G S Mintz; M B Keller; M B Leon
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  127     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1994 Jun 
Date Detail:
Created Date:  1994-06-29     Completed Date:  1994-06-29     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1496-503     Citation Subset:  AIM; IM    
Department of Internal Medicine (Cardiology Division), Washington Hospital Center, Washington, DC 20010.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects,  statistics & numerical data
Atherectomy, Coronary / adverse effects*,  instrumentation,  methods,  statistics & numerical data
Coronary Angiography
Graft Occlusion, Vascular / epidemiology,  etiology*,  radiography,  therapy
Middle Aged
Risk Factors
Saphenous Vein / radiography,  transplantation*
Statistics as Topic
Thromboembolism / epidemiology,  etiology*,  radiography,  therapy
Treatment Outcome

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