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Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg
Published on: November 19, 2019
Peri-procedural outcome of saphenous vein graft intervention
Insights
Percutaneous coronary intervention (PCI) after coronary artery bypass graft (CABG) surgery shows improved success rates for saphenous vein graft intervention. Advancements in techniques and devices contribute to better outcomes for patients with recurrent myocardial ischemia.
Area of Science:
- Cardiology
- Interventional Cardiology
Background:
- Patients with recurrent myocardial ischemia post-coronary artery bypass graft (CABG) often require percutaneous coronary intervention (PCI).
- Evaluating clinical characteristics and peri-procedural outcomes in this patient group is crucial for optimizing treatment strategies.
Purpose of the Study:
- To assess the clinical features and immediate outcomes of patients with prior CABG undergoing PCI.
- To analyze procedural success and complications in patients referred for PCI following CABG surgery.
Main Methods:
- A retrospective analysis of 113 patients who underwent PCI after CABG between November 2006 and October 2009.
- Evaluation of angiographic procedural success and immediate post-procedural outcomes.
Main Results:
- The cohort (n=113) had a mean age of 58.2 years, predominantly male, with high rates of hypertension (57.5%), hyperlipidemia (72.6%), and family history of ischemic heart disease (65.5%).
- Procedural complications included stent closure (0.9%), sub-acute stent thrombosis (0.9%), dissection (2.7%), perforation (0.9%), slow flow (11.5%), and elevated cardiac enzymes (5.3%).
Conclusions:
- Success rates for saphenous vein graft (SVG) intervention have improved over time.
- Technological advancements, including stents and filter devices, alongside improved medications, have enhanced survival rates and procedural success in patients undergoing PCI after CABG.
Background:
Patients who develop recurrent myocardial ischemia after coronary artery bypass graft (CABG) surgery are often referred for percutaneous coronary intervention. The objective of this study was to evaluate the clinical characteristics and peri-procedural outcomes in patients with prior CABG referred for percutaneous coronary intervention (PCI) over a 3 year period.
Methods:
Data were collected on patients who underwent coronary interventional procedures following CABG surgery. We evaluated angiographic procedural success and immediate outcome among patients who had undergone such procedures from Nov 2006 to Oct 2009 (n = 113).
Results:
Patients in the 2006-2009 cohort had mean age 58.2 years, more patients were male (109 vs 4) and were more likely to have hypertension (57.5%), hyperlipidaemia (72.6%) and family history of ischemic heart disease (IHD) (65.5%), but less likely to have smoking (42.5%). Acute closure of stent leading to procedural failure was seen in 1 (0.9%) patient, sub-acute thrombosis of stent was seen in 1 (0.9%) patient, dissection or perforation of target vessel was seen in 3 (2.7%) and 1 (0.9%) patients respectively. Slow flow phenomenon was seen in 13 (11.5%) and post-procedural cardiac enzymes were raised in 6 (5.3%) patients.
Conclusion:
Success rates of saphenous vein graft (SVG) intervention and survival rate have improved with time as a result of improvements in technique and greater use of stents, filter devices and adjunctive medications.
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