Treatment of in-stent restenosis in a gastroepiploic artery coronary bypass graft with brachytherapy.
The pedicled right gastroepiploic artery is used as an arterial conduit in a select group of patients undergoing coronary artery bypass grafting with favorable patency and survival rates. Myocardial ischemia can occur, especially secondary to distal anastomotic stenosis. Percutaneous coronary interventions have been successful in treating these stenoses, precluding further challenging and higher risk operations. The restenosis rate of such interventions is unknown. We describe a case of distal right gastroepiploic graft anastomotic stenosis that was initially treated with percutaneous angioplasty, but later required stenting for restenosis. Subsequent in-stent restenosis was successfully treated with angioplasty and brachytherapy via the left axillary approach.
Hillegass
William B
WB
University of Alabama at Birmingham, Division of Cardiovascular Disease, Birmingham, AL 35294-0012, USA. hillegas@uab.edu
Zoghbi
Gilbert J
GJ
Pandey
Anand
A
Misra
Vijay K
VK
Chapman
Gregory D
GD
Brott
Brigitta C
BC
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D001918:Brachytherapy / Q000379:methods*; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000379:methods; D023903:Coronary Restenosis / Q000209:etiology / Q000532:radiotherapy*; D024405:Gastroepiploic Artery / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation / Q000009:adverse effects*; D015607:Stents / Q000009:adverse effects*