Document Detail


Percutaneous angioscopy of saphenous vein coronary bypass grafts.
MedLine Citation:
PMID:  8459074     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We compared the results of percutaneous angioscopy and angiography for detecting critical elements of surface lesion morphology in 21 patients undergoing balloon angioplasty of saphenous vein coronary bypass grafts. BACKGROUND: Angiography remains the standard for diagnosing and treating intravascular pathology associated with atherosclerotic coronary artery disease. It has been demonstrated that coronary angioscopy is more sensitive for identifying more complex atherosclerotic plaques and intracoronary thrombi in native coronary arteries. METHODS: Angioscopy and angiography were performed before and after angioplasty of "culprit lesions" in bypass grafts. All but one of the patients had unstable angina. The mean age of the saphenous vein coronary bypass grafts was 10.1 +/- 2.4 years (range 5 to 15). RESULTS: Restenosis at a prior angioplasty site was present in seven patients. Intravascular thrombi were seen by angioscopy in 15 (71%) of 21 versus 4 (19%) of 21 grafts by angiography (p < 0.001). Dissection was identified by angioscopy in 14 (66%) of 21 versus 2 (9.5%) of 21 grafts by angiography (p < 0.01). The presence of friable plaque lining the lumen surface of the vein graft was detected by angioscopy in 11 (52%) of 21 versus 4 (19%) of 21 grafts by angiography (p < 0.05). There was no correlation between age of the bypass graft and the finding of friable plaque. CONCLUSIONS: We conclude that angioscopy is superior to angiography for detecting complex lesion morphology in bypass grafts and that the presence of friable plaque does not preclude an uncomplicated angioplasty procedure.
Authors:
C J White; S R Ramee; T J Collins; J E Mesa; A Jain
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  21     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1993 Apr 
Date Detail:
Created Date:  1993-04-29     Completed Date:  1993-04-29     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1181-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, Ochsner Clinic, New Orleans, Louisiana.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary
Angioscopy* / methods
Coronary Angiography*
Coronary Artery Bypass*
Coronary Thrombosis / diagnosis
Female
Graft Occlusion, Vascular / diagnosis*,  pathology,  radiography
Humans
Male
Middle Aged
Recurrence
Saphenous Vein / pathology,  radiography,  transplantation*

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


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