Document Detail

Intervention in the occluded vein graft: with high risk can come great reward. Review of techniques with case examples.
MedLine Citation:
PMID:  23117319     Owner:  NLM     Status:  In-Data-Review    
Total occlusion of a saphenous vein graft (SVG) can present as abrupt thrombotic occlusion in an atherosclerotic graft with resultant acute cardiac events or chronic total occlusion (CTO) with resultant angina symptoms. The risks of percutaneous coronary intervention (PCI) within an occluded graft include not only periprocedural myocardial infarction (MI), but also the risks that come part and parcel with any CTO intervention which include an increased probability of procedural failure, vessel perforation, dissection, high radiation, and contrast exposure, and the potential for worse outcomes. PCI of a chronically occluded graft remains a class III indication in current PCI guidelines because of the increased procedural risk and modest clinical data supporting improved outcomes. Acute-type occlusions, with bulky and thrombotic obstruction, while not specifically addressed in the guidelines, are also fraught with somewhat similar risks. In this review, we describe four case scenarios with occluded SVG and discuss challenges and techniques and available evidence that support these interventions.
Jeffrey Cook; Barry F Uretsky; Rajesh Sachdeva
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  24     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  612-7     Citation Subset:  IM    
Department of Medicine, Division of Cardiology, Central Arkansas Veterans Healthcare System and University of Arkansas for Medical Sciences, 4300 W. 7th Street, Little Rock, AR 72205 USA.
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