Applicability of distal protection for aortocoronary vein graft interventions in clinical practice

Verghese Mathew, Ryan J. Lennon, Charanjit S. Rihal, John F. Bresnahan, David R. Holmes

Research output: Contribution to journalArticle

28 Scopus citations

Abstract

Percutaneous revascularization of diseased saphenous vein grafts is associated with increased risk of adverse events, although the use of distal protection mitigates this to a significant extent. However, anatomic characteristics may preclude the use of such devices in a proportion of vein grafts intended for percutaneous treatment. We reviewed our consecutive experience of saphenous vein graft interventions from 1 May 2001 through 30 April 2002 to determine suitability for distal protection. Relevant angiographic characteristics included lesion within 5 mm of the ostium; lesion < 20 mm from the distal anastomosis; planned distal landing site of the occlusion balloon < 3 mm or > 6 mm in diameter; total occlusion of the vein graft; or lesion in a sequential vein graft distal to the first anastomosis. One hundred twenty-seven patients (140 procedures, 147 vein grafts) were treated. One or more of the angiographic exclusion criteria for a balloon occlusion protection system existed in 57% of grafts, while 42% had exclusions for a filter device. A large number of patients with vein graft disease intended for percutaneous treatment have anatomic exclusions to available distal protection technology.

Original languageEnglish (US)
Pages (from-to)148-151
Number of pages4
JournalCatheterization and Cardiovascular Interventions
Volume63
Issue number2
DOIs
StatePublished - Oct 1 2004

Keywords

  • Atherosclerosis
  • Graft disease

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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