[Interventional therapy of bypass stenoses].
BACKGROUND
Percutaneous balloon angioplasty (PTCA) of lesions in aorto-coronary saphenous vein grafts remains one of the most hazardous procedures in interventional cardiology. It is associated with a high rate of distal embolizations, increased incidence of periprocedural myocardial infarctions and amplified in-hospital and long-term mortality. Moreover, PTCA is complicated by a high rate of restenosis, which did not decline significantly after the implantation of coronary stents.
Herein we review the latest advances in PTCA and stent implantation in vein grafts, discuss the impact of new stent designs, temporary antiaggregatory regimes and mechanic embolus protection devices and point towards future directions, which may help to further improve safety and efficacy of percutaneous interventions in this challenging subgroup of lesions.
Baldus
Stephan
S
Abteilung für Kardiologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.
Hamm
Christian W
CW
D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D004617:Embolism / Q000000981:diagnostic imaging / Q000517:prevention & control; D004867:Equipment Design; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D011859:Radiography; D015607:Stents