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Angioplasty of totally occluded old vein grafts with new interventional techniques: A long-term follow-up study

✍ Scribed by Luo, Jian F. ;Liu, Ming W. ;Wong, Peter M.T. ;Mathur, Atul ;Iyer, Sriram S. ;Baxley, William A. ;Dean, Larry S. ;Roubin, Gary S.


Publisher
John Wiley and Sons
Year
1998
Tongue
English
Weight
42 KB
Volume
44
Category
Article
ISSN
0098-6569

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✦ Synopsis


The long-term patency of saphenous vein graft (SVG) lesions after intervention has been shown to be improved with new interventional techniques such as stents. Long-term outcome of patients undergoing successful angioplasty of totally occluded old SVGs with new devices is unknown. From July 1994 to June 1996, 19 patients with totally occluded old SVGs had successful angioplasty with new interventional techniques. Mean SVG age was 123 +/- 8 mo. Thrombolysis in myocardial infarction trial (TIMI) flow was 0 in all target lesions. TIMI 2 or 3 flow was restored after angioplasty in all patients. Intracoronary urokinase, transluminal extractional atherectomy, and stenting were used in 14, 12, and 6 patients, respectively. There was one in-hospital death due to ongoing myocardial infarction, no recurrent infarction, and no repeat angioplasty or bypass surgery in the hospital. At follow-up of 21 +/- 1 mo, there was one sudden death and one myocardial infarction. Five patients had repeat coronary bypass surgery, and 4 had repeat angioplasty. Thirteen patients remained asymptomatic, and 4 had angina. The long-term outcome of patients who had successful reopening of occluded old SVGs is encouraging in this small sample.