Transcatheter therapy of thrombotic-occlusive lesions in saphenous vein grafts.
Saphenous vein graft (SVG) disease, a form of accelerated atherosclerosis, remains a therapeutic conundrum. The use of stents after excluding the presence of thrombus has proved highly successful at short- and long-term follow-up. We report on 60 severely symptomatic patients with multiple subtotal and total thrombotic SVG occlusions who were treated with a combination of intragraft urokinase-verapamil infusion and insertion of multiple biliary stents. Stent deployment had a 100% success rate. No case of clinical subacute thrombosis was registered, and major in-hospital complications were uncommon (<1%). The clinical outcome was encouraging, with a 12-month event-free survival rate of 87% in the 57 evaluable patients. This method of therapy appears to be highly successful in the treatment of thrombus-containing occlusive SVG disease, in preventing the "no-reflow" phenomenon, and in lessening the incidence of periprocedural non-Q-wave myocardial infarction.
Ceceña
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FA
"Charles A. Barrow" Heart Lung Center, St. Luke's Medical Center, Phoenix, Arizona, 85018, USA.
Hoelzinger
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DH
D000368:Aged; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D018572:Disease-Free Survival; D004867:Equipment Design; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D010960:Plasminogen Activators / Q000008:administration & dosage*; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000637:transplantation*; D015607:Stents; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage*; D014700:Verapamil / Q000008:administration & dosage
D005343:Fibrinolytic Agents; D014700:Verapamil; D010960:Plasminogen Activators; D014568:Urokinase-Type Plasminogen Activator