Percutaneous revascularization strategies in saphenous vein graft lesions: Long-term results

Leal, Sílvio; Teles, Rui Campante; Calé, Rita; Sousa, Pedro Jerónimo; Brito, João; Raposo, Luís; Gonçalves, Pedro Araújo; Baptista, José; Almeida, Manuel; Silva, Aniceto; Mendes, Miguel

doi:10.1016/j.repc.2011.09.019

Cited by 5 publications

(3 citation statements)

References 30 publications

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“…Venous conduits used in bypass surgery develop IH as a natural, physiological vessel wall healing response to resist arterial pressure, in the similar fashion as arteriovenous fistulas used for hemodialysis (51,227,228). It is important to emphasize that we at present lack pharmaceuticals that may control VG disease and rather depend on close clinical surveillance to intervene with surgery or endovascular procedures when lesions, either pure IH or atherosclerotic ones, threaten VG patency (229,230). The thickness of IH in VGs after surgery depends on many factors such as the severity of inflammation, the control of comorbidities, and the magnitude of mechanical and physiological shear stress (28,195,221,223,231).…”

Section: Discussionmentioning

confidence: 99%

Platelet adhesion on endothelium early after vein grafting mediates leukocyte recruitment and intimal hyperplasia in a murine model

Tseng¹,

Chang²,

Lengquist³

et al. 2015

Thromb Haemost

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Intimal hyperplasia (IH) is the substrate for accelerated atherosclerosis and limited patency of vein grafts. However, there is still no specific treatment targeting IH following graft surgery. In this study, we used a mouse model of vein grafting to investigate the potential for early intervention with platelet function for later development of graft IH. We transferred the inferior vena cava (IVC) from donor C57BL/6 mice to the carotid artery in recipients using a cuff technique. We found extensive endothelial injury and platelet adhesion one hour following grafting. Adhesion of leukocytes was distinct in areas of platelet adhesion. Platelet and leukocyte adhesion was strongly reduced in mice receiving a function-blocking antibody against the integrin αIIbβ3. This was followed by a reduction of IH one month following grafting. Depletion of platelets using antiserum also reduced IH at later time points. These findings indicate platelets as pivotal to leukocyte recruitment to the wall of vein grafts. In conclusion, the data also highlight early intervention of platelets and inflammation as potential treatment for later formation of IH and accelerated atherosclerosis following bypass surgery.

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Section: Discussionmentioning

confidence: 99%

Platelet adhesion on endothelium early after vein grafting mediates leukocyte recruitment and intimal hyperplasia in a murine model

Tseng¹,

Chang²,

Lengquist³

et al. 2015

Thromb Haemost

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show abstract

“…Thus, they are more prone to rupture and thrombus formation. [7] Two therapeutic options for vein graft failure are available: either percutaneous intervention (PCI) or repeat bypass. Redo CABG carries an increased risk, and is technically much more difficult especially in case of a patent LIMA graft.…”

Section: Discussionmentioning

confidence: 99%

Rotational Atherectomy Before Stenting in the Body of a Saphenous Vein Graft

Charbel¹

2019

IJCTS

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Management of stenosis of saphenous vein grafts in Coronary artery bypass graft (CABG) patients remains challenging despite the advance in interventional cardiology techniques. Rotational atherectomy is an adjunctive technique used in certain anatomical conditions in native coronary arteries; its use in saphenous vein graft is still contra-indicated by the manufacturer, and has only been reported in few cases in the literature. We report a case of a calcified, non-dilatable, distal saphenous vein graft to Circumflex lesion in a heart failure patient presenting with Non STEMI. The lesion was just proximal to the anastomosis and could not be crossed. Because of high surgical risk, and against manufacturer guidelines, rotational atherectomy of the lesion was performed and was successful with a very good angiographic result. Rotational atherectomy to facilitate percutaneous interventions in saphenous vein graft lesions is feasible, and could be attempted in experienced centers provided the absence of luminal thrombus or dissection.

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“…A summary is provided in Table 1 (Ref. [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ]). Twenty-six studies involving 366,060 patients were included.…”

Section: Clinical Studies Evaluating Pci In Patients With Prior Cabgmentioning

confidence: 99%

Percutaneous Coronary Intervention of Native Artery Versus Bypass Graft in Patients with Prior Coronary Artery Bypass Graft Surgery

Farag¹,

Brilakis²,

Gasparini³

et al. 2022

Rev. Cardiovasc. Med.

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Background: Percutaneous coronary intervention (PCI) is common in patients with prior coronary artery bypass graft surgery (CABG), however, there is limited data on the association between the PCI target-vessel and clinical outcomes. In this article, we provide a state-of-the-art overview of the contemporary management of patients with prior CABG and a clear indication for revascularization. Methods: We performed a structured literature search of PubMed and Cochrane Library databases from inception to March 2021. Relevant studies were extracted and synthesized for narrative review. Results: Twenty-six observational studies focusing on PCI of bypass graft versus native coronary artery lesions in 366,060 patients with prior CABG were included. The data from observational studies suggest that bypass graft PCI is associated with higher short-and long-term major adverse cardiac events compared to native coronary artery PCI. Conclusions: Whenever feasible, native coronary artery PCI should be the prioritized treatment for saphenous vein graft failure. Prospective randomized trials are needed to elucidate the optimal revascularization strategy for patients with prior CABG.

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Percutaneous revascularization strategies in saphenous vein graft lesions: Long-term results

Abstract: Among patients with SVG lesions, long-term mortality, MI and TVF were not affected by intervention options, except for the favorable impact on survival of DES in patients treated in native vessels.

Cited by 5 publications

References 30 publications

Platelet adhesion on endothelium early after vein grafting mediates leukocyte recruitment and intimal hyperplasia in a murine model

Platelet adhesion on endothelium early after vein grafting mediates leukocyte recruitment and intimal hyperplasia in a murine model

Rotational Atherectomy Before Stenting in the Body of a Saphenous Vein Graft

Percutaneous Coronary Intervention of Native Artery Versus Bypass Graft in Patients with Prior Coronary Artery Bypass Graft Surgery

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