Palmaz-Schatz stent implantation in stenosed saphenous vein grafts: Clinical and angiographic follow-up

Strumpf, Robert K.; Mehta, Stephen S.; Ponder, Regina; Heuser, Richard R.

doi:10.1016/0002-8703(92)91041-x

Cited by 53 publications

(16 citation statements)

References 32 publications

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“…[12][13][14][15][16] Previous randomized trials of stent implantation, as compared with balloon angioplasty, have shown superior outcomes in native vessels, and observational reports have suggested favorable results in diseased vein grafts. [17][18][19][20][21][22] Accordingly, we conducted a prospective, randomized trial to compare stent implantation with balloon angioplasty for the treatment of obstructive disease of venous bypass grafts.…”

Section: Resultsmentioning

confidence: 99%

Stent Placement Compared with Balloon Angioplasty for Obstructed Coronary Bypass Grafts

et al. 1997

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Section: Resultsmentioning

confidence: 99%

Stent Placement Compared with Balloon Angioplasty for Obstructed Coronary Bypass Grafts

et al. 1997

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“…3 Two randomized studies have shown that coronary stenting reduces the restenosis rate in native coronary arteries compared with balloon angioplasty, 27,28 and several observational studies have indicated that stenting of saphenous vein grafts is associated with a relatively lower incidence of restenosis (17-30%) than conventional balloon angioplasty. [7][8][9][10][11][12][13][14][15][16] A randomized trial showed that stent implantation is associated with a better clinical outcome than balloon angioplasty, although there was no significant difference in the angiographic restenosis rate. 17 Another problem with the treatment of saphenous vein graft stenosis is distal embolization, with the reported incidence following balloon angioplasty ranging from 3 to 7%.…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9][10][11][12][13][14][15][16][17] The restenosis rate tended to be higher if the lesion was located in the ostial segment or at the distal anastomosis. Eeckhout et al also reported a higher rate of restenosis for lesions at the proximal and distal anastomosis.…”

Section: Restenosismentioning

confidence: 99%

Short-Term Outcome of Stent Implantation in Saphenous Vein Grafts

et al. 2001

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“…176,[210][211][212][213][214][215][216] However, recent studies have suggested more favorable results in diseased vein grafts. [217][218][219][220][221] As compared with repeat coronary artery bypass grafts, it was reported that catheter-based revascularization procedures have similar efficacy for the patient with vein graft disease in the new device era and that the choice of therapy should consider patient preference as well as clinical and angiographic suitability. 222 Although some authors indicate that revascularization strategies in saphenous vein grafts are less often influenced by IVUS than in native arteries, 223 other authors have shown that IVUS provides useful information when applied to this lesion subset.…”

Section: Bypass Graftsmentioning

confidence: 99%

Limitations of coronary angiography compared with intravascular ultrasound: Implications for coronary interventions☆

Yamashita

Colombo

Tobis

1999

Progress in Cardiovascular Diseases

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The use of intravascular ultrasound catheters to produce images of lumen and plaque cross-sectional areas has had a profound effect on the practice of interventional cardiology. This imaging modality provides, for the first time, a low-power microscopic view of vascular anatomy within a living patient. This article will review some of the advantages of intravascular ultrasound imaging compared with angiography when used for diagnostic or interventional therapeutic procedures.Copyright 1999 by W.B. Saunders Company C oronary angiography is the primary mode of imaging coronary artery disease and guiding interventional procedures. Although coronary angiography was essential for the development of catheter-based coronary interventions, as the complexity of interventional cases increased, several limitations of angiography surfaced. Problems associated with coronary intervention, such as acute closure and restenosis, are related in part to properties of the lesion. Angiographic studies have reported inconsistent predictors of such adverse events. 1,2 One of the main reasons for this inconsistency is the limited power of angiography to delineate the complex anatomy of coronary atherosclerotic lesions. Intravascular ultrasound (IVUS) is a technique that provides two-dimensional, tomographic views of the coronary lumen and wall morphology in vivo, which has several advantages compared with angiography. 3 This article reviews the limitations of angiography and describes the information that IVUS imaging provides to complement angiography during diagnostic and interventional procedures. The ability of IVUS to evaluate lesion characteristics and dimensions alters therapeutic decisions and permits the operator to optimize each intervention. Lesion EvaluationEvaluation of coronary atherosclerotic lesions by angiography has been described by the joint American College of Cardiology/American Heart Association (ACC/AHA) committee. 4 This system delineates lesions by the degree of eccentricity and complexity. However, this analysis is limited by the ability of angiography to visualize only the lumen and not the atherosclerotic plaque itself. 91IVUS provides new insights for lesion evaluation because it produces a tomographic view of the artery and it is the only technique that permits visualization of the diseased artery wall in vivo. This capability is especially useful for diagnosing disease when vessels overlap or if there is a short stenosis. In addition, IVUS images are at a higher magnification than angiography, and its internal scale has been shown to be more accurate than angiographic assessment of plaque dimensions. Moreover, the ability of angiography to provide information on tissue characterization is limited. The following discussion will attempt to describe these differences between angiography and IVUS. Tomographic ImagingAn angiogram shows a longitudinal, two-dimensional view of the lumen of the vessel and does not directly show us the pathology, that is, the atherosclerotic plaque. If the plaque impinges on...

show abstract

Palmaz-Schatz stent implantation in stenosed saphenous vein grafts: Clinical and angiographic follow-up

Cited by 53 publications

References 32 publications

Stent Placement Compared with Balloon Angioplasty for Obstructed Coronary Bypass Grafts

Stent Placement Compared with Balloon Angioplasty for Obstructed Coronary Bypass Grafts

Short-Term Outcome of Stent Implantation in Saphenous Vein Grafts

Limitations of coronary angiography compared with intravascular ultrasound: Implications for coronary interventions☆

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