|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
|
|
|
|||||||||
|
|||||||||||
|
J Am Coll Cardiol, 1987; 9:8-17 © 1987 by the American College of Cardiology Foundation |
In a 60 month period (January 1981 to December 1985), 82 patients (79% male with a mean age of 60 years) had 83 saphenous vein grafts and 5 internal mammary artery grafts with a total of 101 stenotic sites treated with percutaneous transluminal coronary angioplasty. The mean time between bypass surgery and angioplasty was 51.2 months. The procedure was technically successful in 85% of patients, 86% of grafts and 85% of the sites attempted. In these cases, the mean diameter stenosis was reduced from 77 +/- 14 to 27 +/- 20% (p less than 0.001), the mean pressure gradient from 49 +/- 16 to 7 +/- 6 mm Hg (p less than 0.001). Emergency coronary artery bypass graft surgery was necessary in one patient (1.2%) whereas myocardial infarction occurred in three patients (3.6%). There were no hospital deaths. Clinical follow-up was obtained in all 82 patients. Before angioplasty, 23% were in Canadian Cardiovascular Society functional class II, 60% in class III and 17% in class IV. With a mean clinical follow-up period of 21.4 +/- 2.3 months, 71% are in class I, 17% in class II and 12% in class III. There were two deaths, 3 months or more after angioplasty, one probably due to graft closure. So far, angiographic follow-up (at 7.9 +/- 2.1 months) has been available in 26 patients. Ten patients (with 10 grafts) exhibited graft restenosis; six of them have had second successful repeat angioplasty. Among the many variables analyzed, statistically significant predictors of success were a higher measured balloon/graft ratio (p less than 0.001), smaller diameter graft (p less than 0.001), and shorter lesion length (p less than 0.01). The only predictor of complication was diffuseness of disease in the graft (p less than 0.05). The statistically significant predictors of recurrence were the residual stenosis after the initial angioplasty (p less than 0.01) and the measured balloon/graft ratio (p less than 0.01). Angioplasty of coronary artery grafts appears to be a feasible and efficacious procedure with a low complication rate. The technique is a satisfactory alternative to repeat surgery in selected patients.
This article has been cited by other articles:
|
|
 |
|
  A. Coolong, D. S. Baim, R. E. Kuntz, A. J. O'Malley, S. Marulkar, D. E. Cutlip, J. J. Popma, and L. Mauri Saphenous Vein Graft Stenting and Major Adverse Cardiac Events: A Predictive Model Derived From a Pooled Analysis of 3958 Patients Circulation, February 12, 2008; 117(6): 790 - 797. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. C. Smith Jr, J. T. Dove, A. K. Jacobs, J. Ward Kennedy, D. Kereiakes, M. J. Kern, R. E. Kuntz, J. J. Popma, H. V. Schaff, D. O. Williams, et al. ACC/AHA guidelines for percutaneous coronary intervention (revision of the 1993 PTCA guidelines): A report of the American College of Cardiology/ American Heart Association Task Force on practice guidelines (Committee to revise the 1993 guidelines for percutaneous transluminal coronary angioplasty) endorsed by the Society for Cardiac Angiography and Interventions J. Am. Coll. Cardiol., June 15, 2001; 37(8): 2239 - 2239. [Full Text] [PDF]
|
|
|
|
|
|
J. M. Ahmed, M. K. Hong, R. Mehran, G. Dangas, G. S. Mintz, A. D. Pichard, L. F. Satler, K. M. Kent, H. Wu, G. W. Stone, et al. Influence of diabetes mellitus on early and late clinical outcomes in saphenous vein graft stenting J. Am. Coll. Cardiol., October 1, 2000; 36(4): 1186 - 1193. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Scavetta, C. Oh, R. Caldron, T. Abdel-Dayem, M. Al-Zaibag, K. R. Jutzy, R. J. Marsa, M. Sjolander, and P. A. Ribeiro Results of Saphenous Vein Graft Stent Implantation: Single Center Results from Use of Oversized Balloon Catheters Angiology, November 1, 1999; 50(11): 891 - 899. [Abstract] [PDF]
|
|
|
|
|
|
J. Lefkovits, D. R. Holmes, R. M. Califf, R. D. Safian, K. Pieper, G. Keeler, E. J. Topol, and f. t. C.-I. Investigators Predictors and Sequelae of Distal Embolization During Saphenous Vein Graft Intervention From the CAVEAT-II Trial Circulation, August 15, 1995; 92(4): 734 - 740. [Abstract] [Full Text]
|
|
|
|
|
|
M. W. Wolfe, G. S. Roubin, M. Schweiger, J. M. Isner, J. J. Ferguson, A. D. Cannon, M. Cleman, H. Cabin, F. Leya, R. Bonan, et al. Length of Hospital Stay and Complications After Percutaneous Transluminal Coronary Angioplasty : Clinical and Procedural Predictors Circulation, August 1, 1995; 92(3): 311 - 319. [Abstract] [Full Text]
|
|
|
|
|
|
D. R. Holmes Jr, E. J. Topol, R. M. Califf, L. G. Berdan, F. Leya, P. B. Berger, P. L. Whitlow, R. D. Safian, A. G. Adelman, M. A. Kellett Jr, et al. A Multicenter, Randomized Trial of Coronary Angioplasty Versus Directional Atherectomy for Patients With Saphenous Vein Bypass Graft Lesions Circulation, April 1, 1995; 91(7): 1966 - 1974. [Abstract] [Full Text]
|
|
|
|
 |
|
 H. K. Najm, D. Leddy, P. J. Hendry, J.-F. Marquis, D. Richardson, and W. J. Keon Postoperative Symptomatic Internal Thoracic Artery Stenosis and Successful Treatment With PTCA Ann. Thorac. Surg., February 1, 1995; 59(2): 323 - 326. [Abstract] [Full Text]
|
|
|
|
|
|
S. C. Wong, J. J. Popma, A. D. Pichard, K. M. Kent, L. F. Satler, G. S. Mintz, Y. C. Chuang, M. K. Hong, C. J. Ditrano, and M. B. Leon Comparison of Clinical and Angiographic Outcomes After Saphenous Vein Graft Angioplasty Using Coronary Versus `Biliary' Tubular Slotted Stents Circulation, January 15, 1995; 91(2): 339 - 350. [Abstract] [Full Text]
|
|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
