Japanese Heart Journal
Online ISSN : 1348-673X
Print ISSN : 0021-4868
Clinical Studies
Procedural Results and Distal Embolization After Saphenous Vein Graft Stenting and Angioplasty for In-stent Restenosis of Grafts
Dilek CicekOben DovenHasan Pekdemir,Ahmet CamsariM. Necdet AkkusV. Gokhan CinTuncay ParmaksizTuna Katircibasi
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Volume 45 (2004) Issue 4 Pages 561-571

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Abstract

Saphenous 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.

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© 2004 by the Japanese Heart Journal
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