Short-Term Outcome of Stent Implantation in Saphenous Vein Grafts

Kuroda, Yuzo; Hara, Kazuhiro; Nakajima, Hiroyuki; Ikari, Yuji

doi:10.1253/jcj.65.265

Cited by 4 publications

(7 citation statements)

References 28 publications

(50 reference statements)

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“…Large-scale, randomized studies should be performed to clarify this. Another abovementioned study revealed that after stenting of SVG, the lesion length and total cholesterol levels were independent predictors of distal embolization [14]. The present study did not possess this kind of data except for hypercholesterolemia, which was not an independent predictor of periprocedural complications.…”

Section: Discussioncontrasting

confidence: 74%

“…The present study did not possess this kind of data except for hypercholesterolemia, which was not an independent predictor of periprocedural complications. Kuroda et al [14] did not observe any no reflow/slow flow during PCI of in-stent restenosis lesions of SVGs. In SVG group from the present study, target lesions were significantly more often restenosis and less frequently de-novo lesions compared to non-IMA/ /SVG group.…”

Section: Discussionmentioning

confidence: 90%

“…Another study, which presented procedural results of multiple SVG stenting demonstrated distal embolization in 3.4% of patients in the single SVG group and in 0.9% of patients in the multiple SVG group [13]. Furthermore, a study performed on 51 patients who underwent stenting of the bypass graft demonstrated distal embolization in 13.6% of PCIs [14]. They also reported lower rates of non-Q MIs in patients treated with stent implantation compared to POBA (2% vs. 7%).…”

Section: Discussionmentioning

confidence: 98%

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Predictors of periprocedural complications in patients undergoing percutaneous coronary interventions within coronary artery bypass grafts

et al. 2020

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Section: Discussioncontrasting

confidence: 74%

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 98%

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Predictors of periprocedural complications in patients undergoing percutaneous coronary interventions within coronary artery bypass grafts

et al. 2020

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“…21) We could not detect any relationships between distal embolization and hypercholesterolemia and lesion length.…”

Section: Discussionmentioning

confidence: 62%

“…The poststenting minimum luminal diameter and percent diameter stenosis are predictors of restenosis. 21) In the Multicenter US Palmaz-Schatz Stent Experiences, the procedural success rate was 97.1%, the restenosis rate was 29.7% in a 6-month angiographic follow-up, and independent predictors of restenosis were restenotic lesions, a smaller reference vessel size, a history of diabetes mellitus, and higher percent poststenting diameter stenosis. 7) We did not observe any no reflow/slow flow during percutaneous angioplasty to ISR lesions of SVGs.…”

Section: Discussionmentioning

confidence: 98%

Procedural Results and Distal Embolization After Saphenous Vein Graft Stenting and Angioplasty for Instent Restenosis of Grafts

et al. 2004

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SUMMARYSaphenous vein graft (SVG) angioplasty is associated with frequent periprocedural complications due to distal embolization and a high risk of restenosis. The purpose of this single-center, retrospective study was to determine the distal embolization incidences and outcomes of stenting for SVG lesions and percutaneous angioplasty for in-stent restenosis of these SVGs.We studied 48 consecutive patients (mean age, 62 ± 7 years, 92% men) who had prior CABG and underwent stent deployment to SVG lesions detected at our institution over a period of 4 years.Mean lesion length was 12.4 ± 3.2 mm. The minimal lumen diameter increased from 0.7 ± 0.3 mm to 3.2 ± 0.4 mm after stenting. Distal embolization as no reflow/slow flow phenomenon occurred in 5 (10%) patients. Angiographic success was achieved in 98% of the patients. Procedural success was achieved in 96% of the patients. No reflow/slow flow phenomenon was observed, particularly in patients with acute coronary syndrome. During the follow-up, 11 patients (23%) had angiographic evidence of restenosis. Lesions were treated with balloon angioplasty and the minimal lumen diameter increased from 2.6 ± 1.1 mm to 3.1 ± 0.3 mm. The angiographic and procedural success rates were both 100%. There were no cases of "no" reflow/slow flow. Restenosis was particularly frequent in patients with diabetes mellitus, hypercholesterolemia, and acute coronary syndrome.Stent implantation in patients with de novo SVG lesions can be achieved with a high rate of angiographic and procedural success. The distal embolization risk is lower during angioplasty of in-stent restenosis lesions of SVGs compared to de novo SVG lesions. (Jpn Heart J 2004; 45: 561-571)

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Procedural Results and Immediate Outcomes following De Novo Saphenous Venous Graft Interventions

2018

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Distal embolization is the detrimental factor in SVG intervention. There is no specific treatment for it except prevention. Guidelines have endorsed the use of embolic protection devices; however, their use is not without complications, and increases the procedural time and cost for the patient. The objective of this study is to analyze the procedural results and immediate outcome in de novo SVG stenting. A retrospective observational study of patients who have undergone SVG-percutaneous coronary intervention at our institute. Baseline clinical, demographic data, intervention details, and in-hospital events are analyzed. Statistical analysis was done using Mini tab version 17. Chi-square testing, odds ratio, and 95% confidence intervals were calculated. The study population included 96 lesions in 80 patients. Average age of the graft was 8.2 ± 4 years. Embolic protection devices were used only in 10%. Angiographic and clinical success was seen in 92.5%. Distal embolization was seen in 7.5%. Drug-eluting stent and shorter stents were associated with lesser distal embolization. Stent length (> 20 mm) proved to be an independent predictor of distal embolization. There was no correlation between distal embolization and age of patient, sex, hypertension, diabetes, and smoking, left ventricular function, age of graft, direct stenting, use of embolic device, and glycoprotein 2b/3a inhibitors. De novo SVG lesions can be stented with a high rate of angiographic and procedural success. Stent length is the only independent predictor of distal embolization. SVG interventions can be safely done in the absence of embolic protection devices irrespective of the graft age.

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Short-Term Outcome of Stent Implantation in Saphenous Vein Grafts

Cited by 4 publications

References 28 publications

Predictors of periprocedural complications in patients undergoing percutaneous coronary interventions within coronary artery bypass grafts

Predictors of periprocedural complications in patients undergoing percutaneous coronary interventions within coronary artery bypass grafts

Procedural Results and Distal Embolization After Saphenous Vein Graft Stenting and Angioplasty for Instent Restenosis of Grafts

Procedural Results and Immediate Outcomes following De Novo Saphenous Venous Graft Interventions

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