Favourable results of treatment of narrowed saphenous vein grafts with Palmaz-Schatz stent implantation.
Although conventional balloon angioplasty of saphenous vein grafts can be performed with an acceptable acute success and complication rate, restenosis remains a major problem. However, this may be overcome by the implantation of Palmaz-Schatz stents. Palmaz-Schatz stent deployment was performed in our institution in 43 patients who were referred for PTCA of stenosed saphenous vein grafts. Thirty-seven were located at the mid-portion of the graft, seven at the ostium and six at the distal anastomosis. Overall, we used 59 standard length (15 mm) Palmaz-Schatz stents and 22 short (7 mm) stents. In 15 lesions (30%) multiple stents were implanted in tandem to treat diffuse disease. Angiographic success was achieved in 47 of the 50 attempted lesions (94%). Major cardiac complications occurred in three patients. Two patients had procedures complicated by the development of a Q wave myocardial infarction, one of whom underwent urgent CABG. One patient died. There was no episode of subacute thrombosis. The angiographic follow-up of 37 lesions (80% of eligible lesions) at a mean time of 5 +/- 2 months (range 1-8) showed a restenosis rate of 11% and residual post-stent diameter stenosis was associated with a significantly higher restenosis rate. However, no restenosis occurred in lesions receiving multiple stents. Clinical follow-up was performed in all patients, and at a mean of 25 months after the procedure, 64% were free from clinical events, including recurrent angina. Palmaz-Schatz stent implantation is an effective and safe procedure to treat narrowed vein grafts.(ABSTRACT TRUNCATED AT 250 WORDS)
Maiello
L
L
Catherization Laboratory, Centro Cuore Columbus, Milan, Italy.
Colombo
A
A
Gianrossi
R
R
Goldenberg
S
S
Martini
G
G
Finci
L
L
D000368:Aged; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D011183:Postoperative Complications; D012008:Recurrence; D012501:Saphenous Vein; D015607:Stents / Q000009:adverse effects