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Applicability of distal protection for aortocoronary vein graft interventions in clinical practice
Author(s) -
Mathew Verghese,
Len Ryan J.,
Rihal Charanjit S.,
Bresnahan John F.,
Holmes David R.
Publication year - 2004
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.20102
Subject(s) - medicine , percutaneous , ostium , surgery , vein , saphenous vein graft , anastomosis , lesion , occlusion , revascularization , balloon , radiology , lumen (anatomy) , cardiology , artery , myocardial infarction
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. Cathet Cardiovasc Intervent 2004;63:148–151. © 2004 Wiley‐Liss, Inc.