Percutaneous Intervention in saphenous venous grafts: In-Stent Restenosis lesions are safer than de novo lesions

Abid R. Assali, Stefano Sdringola, Ali Moustapha, Mohammad Ghani, Hela Achour, Susan Hale, George Schroth, Ken Fujise, H. Vernon Anderson, Richard W. Smalling, Oscar R. Rosales

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)446-450
Number of pages5
JournalJournal of Invasive Cardiology
Volume13
Issue number6
StatePublished - Jun 1 2001

Keywords

  • De novo
  • In-stent restenosis
  • Percutaneous intervention
  • Saphenous vein graft

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Assali, A. R., Sdringola, S., Moustapha, A., Ghani, M., Achour, H., Hale, S., Schroth, G., Fujise, K., Anderson, H. V., Smalling, R. W., & Rosales, O. R. (2001). Percutaneous Intervention in saphenous venous grafts: In-Stent Restenosis lesions are safer than de novo lesions. Journal of Invasive Cardiology, 13(6), 446-450.