Percutaneous transluminal angioplasty of saphenous vein grafts for medically refractory unstable angina

Morrison, Douglass A.; Crowley, Stephen T.; Veerakul, Gumpanart; Barbiere, Charles; Grover, Frederick L.; Sacks, Jerome

doi:10.1016/0735-1097(94)90591-6

Cited by 27 publications

(9 citation statements)

References 32 publications

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“…Three patients were hemodynamically unstable mani-fested by pulmonary wedge pressures 220 mm Hg and systolic blood pressure of < 110 mm Hg. Six patients from this study population were included in our salvage angioplasty paper [6], and four of these six were also included in a study of saphenous vein graft angioplasty [7].…”

Section: Materials and Methods Patientsmentioning

confidence: 99%

Percutaneous transluminal coronary angioplasty of the left main coronary artery in patients with rest angina

Crowley

Morrison

1994

Cathet. Cardiovasc. Diagn.

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Left main coronary angioplasty may be a therapeutic revascularization procedure for a subset of patients with symptomatic coronary artery disease. The purpose of this study is to report procedural outcomes and long-term clinical follow-up of 15 patients who underwent either protected or unprotected left main angioplasty for rest angina. These patients represent a cohort of unstable angina patients who were considered high risk for coronary artery bypass surgery. Ten of 15 patients had Canadian Heart Class IV angina, and three patients were hemodynamically unstable. Balloon angioplasty was successful in 4 patients, and one patient was treated with directional atherectomy. Initial angiographic success was achieved in 14 of 15 patients (93%). Major complications (myocardial infarction, emergent coronary artery bypass graft, death) occurred in one patient (6%); 73% of the patients were asymptomatic or had stable exertional angina at 6 months follow-up. One year survival was 87% (13 of 15). During the follow-up period six patients had repeat catheterization for recurrent angina. Four of these patients had left main restenosis and underwent successful repeat left main angioplasty. No patient had coronary bypass surgery during follow-up. This report suggests that left main angioplasty can be a safe and effective revascularization procedure for critically ill patients with unstable angina who are at high risk for coronary bypass surgery.

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Section: Materials and Methods Patientsmentioning

confidence: 99%

Percutaneous transluminal coronary angioplasty of the left main coronary artery in patients with rest angina

Crowley

Morrison

1994

Cathet. Cardiovasc. Diagn.

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“…Until recently, the standard treatment of SVG atherosclerosis was to repeat CABG [2]. However, angioplasty alone [3,4,5,6] and angioplasty with stenting [7,8,9,10,11] have emerged as alternative treatment options in the last years. Thus, treatment of SVG disease currently accounts for about 10% of all percutaneous coronary interventions (PCI) [12].…”

Section: Introductionmentioning

confidence: 99%

Drug-Eluting Stents Compared with Bare Metal Stents Improve Late Outcome after Saphenous Vein Graft but Not after Large Native Vessel Interventions

et al. 2008

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Objectives: To define long-term efficacy of different stent types in saphenous vein graft (SVG) interventions. Methods: In BASKET (Basel Stent Cost Effectiveness Trial), major adverse cardiac events (MACE), i.e. cardiac death, myocardial infarction and symptom-driven target vessel revascularization (TVR) were assessed after 18 months comparing drug-eluting stents (DES) versus bare metal stents (BMS), and SVG and large native vessels (≧3.0 mm). Results: Large vessel interventions were performed in 605 patients. Patients with SVG interventions (n = 47, 8%) were older and had more often hypertension, prior myocardial infarction, prior revascularization and multivessel disease and less frequent ST-elevation myocardial infarction than patients with large native vessel interventions (n = 558, 92%). Stent number and length were higher in SVG than in large native vessel interventions. Baseline characteristics were similar for DES and BMS. In SVG stenting, long-term outcome was better in DES- than in BMS-treated patients (MACE 21 vs. 62%, p = 0.007, mainly due to TVR 18 vs. 46%, p = 0.045), but for large native vessel stenting, no significant difference was noted (MACE: 13 vs. 16%, p = 0.40). Conclusions: Among patients with SVG disease, treatment with DES resulted in a better long-term outcome than treatment with BMS. In contrast, no DES benefit was found in similarly sized native vessels regarding MACE.

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“…Ninety‐five percent of patients had PCI with stent deployment and only a small number of patients had balloon angioplasty only. This is in keeping with the notion that percutaneous transluminal coronary angioplasty alone proved to be inadequate therapy with unacceptably high rates of restenosis and major adverse cardiac events . More than half of these patients underwent DES deployment with the rate of DES use increasing over the course of the study.…”

Section: Discussionmentioning

confidence: 99%

Characteristics and outcomes of patients undergoing percutaneous coronary intervention within 1 year of coronary artery bypass graft surgery

Sharma

Kotowycz

Sharma

et al. 2017

Cathet Cardio Intervent

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Patients who required PCI within 1 year of CABG were more likely to present on an urgent basis and have PCI performed in grafted native coronary vessels. However, nearly third of the patients had PCI to an ungrafted native vessel or to a lesion in the native vessel where the graft was still patent. Further studies are needed to determine whether the use of hybrid revascularization strategies (combination CABG and planned PCI) in appropriate patients could reduce the need for urgent PCI within the first year after CABG. © 2017 Wiley Periodicals, Inc.

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Percutaneous transluminal angioplasty of saphenous vein grafts for medically refractory unstable angina

Abstract: Balloon angioplasty of saphenous vein grafts with aggressive adjunctive pharmacotherapy is a reasonable alternative to repeat coronary bypass graft surgery in patients with medically refractory unstable angina, previous coronary bypass graft surgery and saphenous vein narrowing.

Cited by 27 publications

References 32 publications

Percutaneous transluminal coronary angioplasty of the left main coronary artery in patients with rest angina

Percutaneous transluminal coronary angioplasty of the left main coronary artery in patients with rest angina

Drug-Eluting Stents Compared with Bare Metal Stents Improve Late Outcome after Saphenous Vein Graft but Not after Large Native Vessel Interventions

Characteristics and outcomes of patients undergoing percutaneous coronary intervention within 1 year of coronary artery bypass graft surgery

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