Document Detail


Effect of percutaneous coronary interventions for in-stent restenosis in degenerated saphenous vein grafts without distal embolic protection.
MedLine Citation:
PMID:  12628717     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study was designed to investigate the impact of percutaneous coronary interventions (PCIs) in degenerated saphenous vein grafts (SVGs) without distal embolic protection. BACKGROUND: Distal embolic protection devices have been shown to reduce the incidence of no reflow/slow flow during PCI of de novo lesions in degenerated SVGs. It is unclear whether PCI of in-stent restenosis (ISR) lesions in degenerated SVGs is associated with no reflow/slow flow and whether distal embolic protection is beneficial in these cases as well. METHODS: We studied 54 consecutive patients with treated ISR lesions in degenerated SVGs who underwent PCI without distal embolic protection in a single center. Procedural and in-hospital outcomes were examined. The average age was 71 +/- 8 years; 32% of the patients had diabetes. The mean lesion length was 13 +/- 6 mm and the procedural success rate was 98% (53/54). Cutting balloon angioplasty was used in 46% (25/54) of cases, and a new stent was inserted in 46% (25/54) of patients. Gamma brachytherapy was performed in 19% (10/54) of patients. During the procedure there were no episodes of no reflow/slow flow, and there were no patients with in-hospital Q-wave or non-Q-wave myocardial infarction. There was one in-hospital noncardiac death. CONCLUSIONS: In this consecutive series of patients with ISR of degenerated SVGs undergoing PCI without distal protection, there were no episodes of slow flow/no reflow and no procedure-related myocardial infarctions. It appears that distal embolic protection may not be necessary during PCI of ISR lesions in degenerated SVGs.
Authors:
Dale T Ashby; George Dangas; Eve A Aymong; Ioannis Iakovou; Frank Kuepper; Roxana Mehran; Gregg W Stone; Martin B Leon; Jeffery W Moses
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  41     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-03-11     Completed Date:  2003-03-27     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  749-52     Citation Subset:  AIM; IM    
Affiliation:
Lenox Hill Heart and Vascular Institute, New York, New York, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Angioplasty, Transluminal, Percutaneous Coronary / methods*
Cohort Studies
Coronary Angiography
Coronary Artery Bypass / adverse effects*,  methods,  mortality
Coronary Circulation
Coronary Restenosis / radiography,  therapy*
Coronary Stenosis / diagnosis,  mortality,  surgery*
Embolism / prevention & control
Female
Follow-Up Studies
Graft Occlusion, Vascular / radiography,  therapy*
Humans
Length of Stay
Male
Prospective Studies
Risk Assessment
Saphenous Vein / transplantation*
Severity of Illness Index
Stents
Survival Rate
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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