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• W2079720594 abstract "Previously, we reported the high incidence of ischemic complications due to distal embolization (DE) following extraction atherectomy (TEC) of degenerated saphenous vein grafts (DSVG: grafts with lumen ectasia or irregularities comprising ≥50% of the graft length), frequently caused by adjunct PTCA (Group I). To assess whether a staged strategy (initial stand-alone TEC ± lyric therapy, followed by coumadin and stenting 1–2 months later) could reduce ischemic complications, we performed a pilot study in 28 pts with DSVG (Group II). Demographics and graft age (100 ± 47 vs. 99 ± 42 months) were similar, except for more recent MI in Group II (58.3% vs. 22.7%, P = 0.03). Group I (n = 44) Group II (n = 28) % DS (Pre/Final) 79 ± 14/30 ± 24 * 80 ± 17/45 ± 19 DE (%) 22.7 ** 10.7 Any In-hospital Complications 11.4% *** 0% Death/CABG/MI (%) 6.8/2.3/4.5 0/0/0 DS = diameter stenosis * p < 0.001 ** p = 0.20 *** p = 0.15 vs. Group II Among 27 pts in Group II eligible for follow-up (> 1 month), there were no major ischemic complications. There were 4 total occlusions [1 non-Q wave MI at 4 months and 3 silent occlusions at 6 weeks (1) and 2 months (2)]. 9 without clinical indication for additional therapy, 11 staged procedures with stenting (follow-up % DS = 56 ± 30%), and 3 without significant stenosis on follow-up angiography. We conclude that this staged angioplasty strategy in degenerated saphenous vein graft lesions: 1) may reduce distal embolization, but most importantly , avoids major in-hospital ischemic complications during the initial procedure: but 2) at the expense of ≈15% graft occlusions, which occurred more than 6 weeks after the initial procedure: and 3) prevented any deaths either during the initial procedure or during the follow-up period. These results underscore the importance of early (1 month) follow-up in all patients undergoing this staged TEC, followed by stent procedure in treating complex degenerated saphenous vein graft lesions." @default.
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• W2079720594 date "1995-02-01" @default.
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• W2079720594 title "1018-49 Assessing a Strategy of Stand-alone Extraction Atherectomy Followed by Staged Stent Placement in Degenerated Saphenous Vein Graft Lesions" @default.
• W2079720594 doi "https://doi.org/10.1016/0735-1097(95)93090-y" @default.
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