Prevalence and outcomes of intermediate saphenous vein graft lesions: Findings from the stenting of saphenous vein grafts randomized-controlled trial

Abdel-Karim, Abdul Rahman R; Silva, Monica Da; Lichtenwalter, Christopher; Lemos, James A. de; Obel, Owen; Addo, Tayo; Roesle, Michele; Haagen, Donald; Rangan, Bavana V.; Makke, Lorenza; Jeroudi, Omar M.; Raghunathan, Deepa; Saeed, Bilal; Bissett, Joe K.; Sachdeva, Rajesh; Voudris, V.; Karyofillis, Panagiotis; Kar, Biswajit; Rossen, James D.; Fasseas, Panayotis; Berger, Peter B.; Banerjee, Subhash; Brilakis, Emmanouil S.

doi:10.1016/j.ijcard.2013.03.006

Cited by 19 publications

(4 citation statements)

References 16 publications

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“…SVGs were considered good potential conduit for a retrograde procedure when they were highly degenerated but patent, therefore at high risk for subsequent occlusion if treated with PCI. 7,15,18 Also, SVGs presenting with recurrent in-stent restenosis were considered appropriate subset to consider treatment of the native artery CTO rather than the graft. Finally, occluded SVGs were also good conduits as long as a proximal tapered stump could be identified ( Figure 1).…”

Section: What the Study Addsmentioning

confidence: 99%

Recanalization of Chronic Total Occlusions in Patients With Previous Coronary Bypass Surgery and Consideration of Retrograde Access via Saphenous Vein Grafts

Dautov

Nguyen

Altisent

et al. 2016

Circ: Cardiovascular Interventions

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Background-The prevalence of native coronary chronic total occlusions (CTOs) after coronary artery bypass grafts (CABGs) is higher than in non-CABG population. We examined outcomes of CTO percutaneous coronary intervention (PCI) post-CABG versus without CABG. Then, we looked at feasibility and outcomes of retrograde CTO PCI via patent or occluded saphenous vein graft. Methods and Results-We compared patient and procedural characteristics of 470 CTO cases treated from January 2010 to December 2015 depending on history of CABG. We assessed major adverse cardiac events, including cardiac death, myocardial infarction, ischemia-driven target-vessel revascularization, or reocclusion 1 year after successful CTO PCI in patients treated before February 2015. Post-CABG patients (175 cases) had a higher J-CTO score (2.5 versus 2.1; P=0.002). In-hospital complications were similar, although the incidence of contrast-induced nephropathy was higher in post-CABG patients (4.6% versus 1%; P=0.01). With multivariable analysis, post-CABG status was associated with higher incidence of 1-year major adverse cardiac event (hazards ratio=2.2; P=0.02). As a second level analysis, we looked at the feasibility and safety of CTO PCI via saphenous vein grafts (19% of post-CABG cases) versus collateral channels (36%) versus with an antegrade-only approach (45%), and assessed short-term outcomes and complications. High success was achieved in the saphenous vein graft group. In-hospital events were similar in the 3 groups. Conclusions-Post-CABG CTO PCI is associated with similar high success and low complications compared with CTO PCI in patients who never had CABG. However, it is associated with higher recurrent events at 1 year. To achieve high success rate, use of saphenous vein grafts as retrograde conduits seems to be safe and effective. (Circ Cardiovasc Interv. 2016;9:e003515.

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Section: What the Study Addsmentioning

confidence: 99%

Recanalization of Chronic Total Occlusions in Patients With Previous Coronary Bypass Surgery and Consideration of Retrograde Access via Saphenous Vein Grafts

Dautov

Nguyen

Altisent

et al. 2016

Circ: Cardiovascular Interventions

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“…They found that smoking (OR = 1.50, 95% CI: 1.08–2.08, p = 0.01) and increased age per 10 years (OR = 1.21, 95% CI: 1.07–1.37, p = 0.01) are among independent predictors of 30-day MACE [31]. The relation between smoking and the progression of intermediate SVG lesions into severely stenosed lesions during a median of 35 months of follow-up was also reported by Abdel-Karim et al [11]. These findings are in line with our results which revealed that smoking was an independent predictor of FRB and LRP occurrence.…”

Section: Discussionmentioning

confidence: 58%

“…Risk factors of accelerated atherosclerosis are similar to those for native coronary atherosclerosis, but their relation to the SVG plaque composition was not described previously. Moreover, non-significant lesions are frequently associated with progression of the narrowing, which can manifest as acute coronary syndrome (ACS) [11, 12].…”

Section: Introductionmentioning

confidence: 99%

Prediction models for different plaque morphology in non-significantly stenosed regions of saphenous vein grafts assessed with optical coherence tomography

Kubiak¹,

Dobrolińska²,

Pociask³

et al. 2018

pwki

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IntroductionCoronary artery bypass grafting (CABG) is a method of choice in treatment of diffuse coronary artery disease (CAD), although it has some limitations such as late saphenous vein graft (SVG) patency loss, which occurs in one fifth of all conduits at 5 years. Since atherosclerosis in SVG has diffuse characteristics, it appears that significantly and non-significantly stenosed lesions may have an equal impact on worse prognosis.AimTo assess non-significant lesions of SVG by the use of optical coherence tomography (OCT) and investigate the clinical and laboratory findings with the potential impact on plaque composition.Material and methodsTwenty-nine patients with 43 non-significant lesions were enrolled in the study. All variables were assessed using uni- and multivariable logistic regression analysis with each plaque morphology as a dependent variable. Odds ratio (OR) and 95% confidence interval (CI) were computed.ResultsPlaque rupture (PRT) was independently associated with age (OR = 1.49, 95% CI: 1.09–2.04, p = 0.015) and lower rates of high-density lipoproteins (HDL) cholesterol (OR = 0.67, 95% CI: 0.49–0.92, p = 0.016). Intimal tearing or rupture (ITR) was related to reduced GFR (OR = 0.52, 95% CI: 0.38–0.72, p = 0.0004). Lipid-rich plaque (LRP) was associated with raised platelet count (PLT) (OR = 1.51, 95% CI: 1.16–1.96, p = 0.004) and increased frequency of smoking (OR = 1.45, 95% CI: 1.12–1.89, p = 0.007).ConclusionsAtherosclerosis of SVG is not restricted to significantly stenosed lesions. Plaque composition is independently associated with different types of clinical and laboratory findings, mostly recognized as risk factors of CAD.

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“…[2][3][4][5][6][7][8][9][10] The incidence of cardiac events related to the progression of intermediate SVG lesions was 19% at 1-year follow-up and increased to 33% at 5-year follow-up in the pilot single-center VELETI trial. 9,10 Of note, all cases of SVG failure were related to SVG disease progression at the level of the intermediate SVG lesion and led to an acute coronary syndrome in most cases.…”

Section: Resultsmentioning

confidence: 99%

Sealing Intermediate Nonobstructive Coronary Saphenous Vein Graft Lesions With Drug-Eluting Stents as a New Approach to Reducing Cardiac Events

Rodés‐Cabau

Jolly

Cairns

et al. 2016

Circ: Cardiovascular Interventions

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S aphenous vein graft (SVG) atherosclerosis after coronary artery bypass grafting (CABG) remains the primary cause of late graft failure, with SVG obstruction rates as high as 50% having been reported 10 years post-CABG. . Patients were randomized (1:1) to DES implantation (SVG-DES) or medical treatment (SVG-MT) of the target SVG lesion. The primary efficacy outcome was the first occurrence of MACE defined as the composite of cardiac death, myocardial infarction, or coronary revascularization related to the target SVG during the duration of follow-up (minimum of 2 years). Secondary efficacy outcomes included MACE related to the target SVG lesion and overall MACE. A total of 125 patients (mean age 70±9 years, 87% men) were included, with a mean time from coronary artery bypass graft of 12±5 years. Sixty and 65 patients were allocated to the SVG-DES and SVG-MT groups, respectively. There were no events related to the target SVG at 30 days. After a median follow-up of 3.4 (interquartile range: 2.8-3.9) years, the MACE rate related to the target SVG was not significantly different in the 2 groups (SVG-DES: 15.0%, SVG-MT: 20.0%; hazard ratio, 0.65; 95% confidence interval, 0.

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Prevalence and outcomes of intermediate saphenous vein graft lesions: Findings from the stenting of saphenous vein grafts randomized-controlled trial

Cited by 19 publications

References 16 publications

Recanalization of Chronic Total Occlusions in Patients With Previous Coronary Bypass Surgery and Consideration of Retrograde Access via Saphenous Vein Grafts

Recanalization of Chronic Total Occlusions in Patients With Previous Coronary Bypass Surgery and Consideration of Retrograde Access via Saphenous Vein Grafts

Prediction models for different plaque morphology in non-significantly stenosed regions of saphenous vein grafts assessed with optical coherence tomography

Sealing Intermediate Nonobstructive Coronary Saphenous Vein Graft Lesions With Drug-Eluting Stents as a New Approach to Reducing Cardiac Events

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