| Treatment of no-reflow in degenerated saphenous vein graft interventions: comparison of intracoronary verapamil and nitroglycerin. | |
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MedLine Citation:
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PMID: 8922307 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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No-flow has been reported after 10-15% of percutaneous interventions on degenerated saphenous vein grafts. In this prospective study of 36 degenerated saphenous vein graft lesions (32 patients), no-flow (TIMI flow < 3 in the absence of a significant lesion or dissection) occurred in 15/36 (42%) lesions. A total of 32 episodes of no-flow occurred after angioscopy (n = 14), extraction atherectomy (n = 10), balloon angioplasty (n = 2) or stent implantation (n = 6). Intragraft nitroglycerin (100-300 micrograms) alone resulted in no improvement in TIMI flow in the setting of no-reflow (TIMI flow 1.2 +/- 0.6 to 1.4 +/- 0.8, P = NS). Intragraft verapamil (100-500 micrograms) resulted in improvement in flow in all 32 episodes (TIMI flow 1.4 +/- 0.8 before, to 2.8 +/- 0.5 after verapamil, P < 0.001). Although verapamil increased TIMI flow after all episodes of no-reflow, two (6.3%) had persistent no-reflow (TIMI 1) despite verapamil, associated with non-Q wave myocardial infarction. In conclusion, treatment of no-reflow with verapamil during degenerated vein graft interventions was associated with reestablishment of TIMI 3 flow in 88% of cases. In contrast, intragraft nitroglycerin alone was ineffective for reversing no-reflow. |
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Authors:
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B M Kaplan; K H Benzuly; J W Kinn; T R Bowers; F V Tilli; C L Grines; W W O'Neill; R D Safian |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Catheterization and cardiovascular diagnosis Volume: 39 ISSN: 0098-6569 ISO Abbreviation: Cathet Cardiovasc Diagn Publication Date: 1996 Oct |
Date Detail:
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Created Date: 1997-02-26 Completed Date: 1997-02-26 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7508512 Medline TA: Cathet Cardiovasc Diagn Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 113-8 Citation Subset: IM |
Affiliation:
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Division of Cardiology (Department of Internal Medicine), William Beaumont Hospital, Royal Oak, Michigan 48073, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Calcium Channel Blockers* / administration & dosage, therapeutic use Coronary Angiography Coronary Artery Bypass / adverse effects* Female Graft Occlusion, Vascular / drug therapy*, etiology, radiography Graft Survival / drug effects Humans Injections, Intra-Arterial Male Middle Aged Nitroglycerin* Prognosis Prospective Studies Regional Blood Flow / physiology Saphenous Vein / physiology* Vasodilator Agents* / administration & dosage, therapeutic use Verapamil* / administration & dosage, therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Calcium Channel Blockers; 0/Vasodilator Agents; 52-53-9/Verapamil; 55-63-0/Nitroglycerin |
| Comments/Corrections | |
Comment In:
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Cathet Cardiovasc Diagn. 1996 Oct;39(2):119
[PMID:
8922308
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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