title: Angioplasty of the internal thoracic artery bypass-graft an alternative to reoperation.
abstract: BACKGROUND
  This review presents an overview of interventional revascularization procedures of the internal thoracic artery after prior implantation as a coronary-artery bypass graft.
  
  
  METHODS
  Our search was concentrated on the MEDLINE-database to identify all articles on internal thoracic artery-graft-angioplasties and reoperation after internal thoracic artery bypass grafting published between 1968 and 2000.
  
  
  RESULTS
  Surgical revascularization and reoperation were reported in five papers including a total of 785 patients. The overall mortality of these patients was 4.2%. The presence of a patent internal thoracic artery-graft at the time of reoperation was not a risk factor for higher morbidity and mortality. Revascularization with percutaneous transluminal coronary angioplasty of the internal thoracic artery or the native left anterior descending artery via the internal thoracic artery-graft used as a conduit was performed in 327 patients. The primary success rate was 87%, the angiographically assessed rate of restenosis was 30% and the rate of complications approximately 1%.
  
  
  CONCLUSIONS
  In spite of technical problems the percutaneous transluminal coronary angioplasty in or via internal thoracic artery-graft presents a safe and feasible option to be recognized before a potential reoperation.
authors.affiliation: Heart Center Wuppertal, Department of Cardiology, University of Witten-Herdecke, Gotenstrasse 1, 42653 Solingen, Germany. RogerMarx@t-online.de
authors.forename: Roger
authors.initials: R
authors.lastname: Marx
authors.forename: Rolf-Michael
authors.initials: RM
authors.lastname: Klein
authors.forename: Marc
authors.initials: M
authors.lastname: Horlitz
authors.forename: Thomas
authors.initials: T
authors.lastname: Ketteler
authors.forename: Christiana Mira
authors.initials: CM
authors.lastname: Schannwell
authors.forename: Harald
authors.initials: H
authors.lastname: Lapp
authors.forename: Hartmut
authors.initials: H
authors.lastname: Gülker
mesh_terms: D000800:Angioplasty, Balloon / Q000379:methods*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D006083:Graft Occlusion, Vascular / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008323:Mammary Arteries / Q000503:physiopathology / Q000601:surgery*; D012086:Reoperation