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 journalArticlepeer-review

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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