title: Novel distal occluder washout method for prevention of no-reflow during stenting of saphenous vein grafts.
abstract: This study assessed safety of the distal occlusion washout (DOW) method for prevention of no-reflow during stenting of degenerated saphenous vein grafts (SVGs). The DOW method involves protection of distal native coronary circulation with an occlusive balloon during the pretreatment and washout steps prior to stenting. Outcomes of stenting of 23 grafts in 21 patients after pretreatment with the DOW method were evaluated. The mean graft age was 7.4 +/- 4.3 years. The mean treated lesion length was 53 +/- 28 mm. Total occlusions were treated in 6 grafts and thrombotic lesions in 10 nontotally occluded grafts. One non-Q-wave MI and one acute stent thrombosis were observed. No deaths, Q-wave MIs, or subacute thromboses occurred. Follow-up in 18/21 (85.7%) patients at 28 +/- 8 weeks demonstrated target graft revascularization in 1 (5%) patient. The DOW method prevented clinically significant no-reflow in all 23 degenerated SVGs stented.
authors.affiliation: Department of Medicine, New York Hospital, Cornell University Medical College, New York, USA.
authors.forename: A
authors.initials: A
authors.lastname: Shaknovich
authors.forename: S T
authors.initials: ST
authors.lastname: Forman
authors.forename: M A
authors.initials: MA
authors.lastname: Parikh
authors.forename: E
authors.initials: E
authors.lastname: Deutsch
authors.forename: G W
authors.initials: GW
authors.lastname: Bergman
authors.forename: T A
authors.initials: TA
authors.lastname: McCaffrey
authors.forename: G C
authors.initials: GC
authors.lastname: Newman
authors.forename: N
authors.initials: N
authors.lastname: Tarazona
authors.forename: T A
authors.initials: TA
authors.lastname: Sanborn
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D017023:Coronary Angiography; D003326:Coronary Circulation; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005374:Filtration; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000637:transplantation*; D015607:Stents; D007507:Therapeutic Irrigation; D016896:Treatment Outcome