TY - JOUR
T1 - Percutaneous Intervention in saphenous venous grafts
T2 - In-Stent Restenosis lesions are safer than de novo lesions
AU - Assali, Abid R.
AU - Sdringola, Stefano
AU - Moustapha, Ali
AU - Ghani, Mohammad
AU - Achour, Hela
AU - Hale, Susan
AU - Schroth, George
AU - Fujise, Ken
AU - Anderson, H. Vernon
AU - Smalling, Richard W.
AU - Rosales, Oscar R.
PY - 2001/6
Y1 - 2001/6
N2 - Background. The histological appearance of stenosis in de novo saphenous venous grafts (DNSVG) consists of diffuse atherosclerosis that contains blood elements, necrotic debris and limited fibrocollagenous tissue. The friable nature of these lesions complicates percutaneous intervention (PCI) procedures. On the other hand, in-stent restenosis (ISR) of SVG is due primarily to atherosclerotic plaque or fibromuscular hyperplasia, with thrombus formation playing a secondary role. The purpose of this study is to compare the results of PCI in these two types of SVG lesions. Methods. We reviewed our institutional interventional database from March 1996 through February 2000 and identified all consecutive patients who underwent PCI of at least one SVG. One hundred and ten patients were identified: 89 undergoing DNSVG intervention and 21 patients with ISR lesions. Results. Acute coronary syndromes, degenerated and thrombus-containing lesions were more common in the DNSVG group. "Slow-, no-reflow" complicated 20% of the DNSVG lesions compared to none of the ISR lesions (p = 0.02). Post-procedural myocardial infarction was higher in the DNSVG group (13.5% versus 0%; p = 0.1) and correlated significantly with the occurrence of "slow-, no-reflow" (r = 0.43; p = 0.0001). Utilizing statistical modeling to adjust for baseline differences between the groups, ISR lesions were associated with a low risk of procedural complications (r = 0.22; p = 0.03). Conclusion. This study demonstrates that in this relatively high-risk population, PCI is safer in ISR lesions than in de novo SVG lesions.
AB - Background. The histological appearance of stenosis in de novo saphenous venous grafts (DNSVG) consists of diffuse atherosclerosis that contains blood elements, necrotic debris and limited fibrocollagenous tissue. The friable nature of these lesions complicates percutaneous intervention (PCI) procedures. On the other hand, in-stent restenosis (ISR) of SVG is due primarily to atherosclerotic plaque or fibromuscular hyperplasia, with thrombus formation playing a secondary role. The purpose of this study is to compare the results of PCI in these two types of SVG lesions. Methods. We reviewed our institutional interventional database from March 1996 through February 2000 and identified all consecutive patients who underwent PCI of at least one SVG. One hundred and ten patients were identified: 89 undergoing DNSVG intervention and 21 patients with ISR lesions. Results. Acute coronary syndromes, degenerated and thrombus-containing lesions were more common in the DNSVG group. "Slow-, no-reflow" complicated 20% of the DNSVG lesions compared to none of the ISR lesions (p = 0.02). Post-procedural myocardial infarction was higher in the DNSVG group (13.5% versus 0%; p = 0.1) and correlated significantly with the occurrence of "slow-, no-reflow" (r = 0.43; p = 0.0001). Utilizing statistical modeling to adjust for baseline differences between the groups, ISR lesions were associated with a low risk of procedural complications (r = 0.22; p = 0.03). Conclusion. This study demonstrates that in this relatively high-risk population, PCI is safer in ISR lesions than in de novo SVG lesions.
KW - De novo
KW - In-stent restenosis
KW - Percutaneous intervention
KW - Saphenous vein graft
UR - http://www.scopus.com/inward/record.url?scp=0035374701&partnerID=8YFLogxK
M3 - Article
C2 - 11385167
AN - SCOPUS:0035374701
SN - 1042-3931
VL - 13
SP - 446
EP - 450
JO - Journal of Invasive Cardiology
JF - Journal of Invasive Cardiology
IS - 6
ER -