Follow-up results after interventional treatment of infarct-related saphenous vein graft occlusion

Autor: Rainer Hoffmann, Umar Adamu, Felix Vogt, M. Almalla, Rüdiger Blindt, Giadino Nitendo, Verena Deserno
Rok vydání: 2010
Předmět:
Zdroj: Coronary Artery Disease. 21:61-64
ISSN: 0954-6928
DOI: 10.1097/mca.0b013e328332ee4b
Popis: Acute occlusion of saphenous vein grafts resulting in acute coronary syndromes may be treated with interventional revascularization. Few data are available on intermediate and long-term results after revascularization of acute saphenous vein graft occlusion.Fifty patients (67+/-10 years, 47 male) with troponin-positive acute coronary syndrome because of acute total or subtotal occlusion [thrombolysis in myocardial infarction (TIMI) flow 0=39, TIMI 1=8, TIMI 2=3] of one saphenous vein graft (12.0+/-5.3 years after surgery, 3.6+/-0.9 grafts) were treated with percutaneous coronary intervention (39 patients using bare-metal stents, 11 patients using drug-eluting stents). Clinical follow-up was obtained in all patients. Angiographic 6-month follow-up was performed in 35 patients (70%).Acute revascularization of the infarct-related saphenous vein graft (lesion length 17.6+/-10.3 mm, reference diameter 3.1+/-0.8 mm) was possible in 94% of patients. After a mean follow-up of 32.5+/-17.4 months, 13 patients (26%) died, 13 patients (26%) had recurrent myocardial infarction, and 20 patients (40%) had recurrent coronary revascularization (percutaneous coronary intervention or coronary artery bypass grafting). Angiographic follow-up showed reocclusion of the vein graft in three cases (9%). Twenty-one percent of lesions were found to be restenotic.Acute revascularization of an infarct-related saphenous vein graft is possible in the majority of cases. Angiographic follow-up data show a high patency rate at 6-month follow-up. Still, the clinical prognosis of patients with revascularized infarct-related saphenous vein graft is quite poor.
Databáze: OpenAIRE