title: Follow-up results after interventional treatment of infarct-related saphenous vein graft occlusion.
abstract: BACKGROUND
  Acute occlusion of saphenous vein grafts resulting in acute coronary syndromes may be treated with interventional revascularization. Few data are available on intermediate and long-term results after revascularization of acute saphenous vein graft occlusion.
  
  
  METHODS
  Fifty patients (67+/-10 years, 47 male) with troponin-positive acute coronary syndrome because of acute total or subtotal occlusion [thrombolysis in myocardial infarction (TIMI) flow 0=39, TIMI 1=8, TIMI 2=3] of one saphenous vein graft (12.0+/-5.3 years after surgery, 3.6+/-0.9 grafts) were treated with percutaneous coronary intervention (39 patients using bare-metal stents, 11 patients using drug-eluting stents). Clinical follow-up was obtained in all patients. Angiographic 6-month follow-up was performed in 35 patients (70%).
  
  
  RESULTS
  Acute revascularization of the infarct-related saphenous vein graft (lesion length 17.6+/-10.3 mm, reference diameter 3.1+/-0.8 mm) was possible in 94% of patients. After a mean follow-up of 32.5+/-17.4 months, 13 patients (26%) died, 13 patients (26%) had recurrent myocardial infarction, and 20 patients (40%) had recurrent coronary revascularization (percutaneous coronary intervention or coronary artery bypass grafting). Angiographic follow-up showed reocclusion of the vein graft in three cases (9%). Twenty-one percent of lesions were found to be restenotic.
  
  
  CONCLUSIONS
  Acute revascularization of an infarct-related saphenous vein graft is possible in the majority of cases. Angiographic follow-up data show a high patency rate at 6-month follow-up. Still, the clinical prognosis of patients with revascularized infarct-related saphenous vein graft is quite poor.
authors.affiliation: Medical Clinic I, University RWTH Aachen, 52057 Aachen, Germany. RHoffmann@UKAACHEN.de
authors.forename: Rainer
authors.initials: R
authors.lastname: Hoffmann
authors.forename: Giadino
authors.initials: G
authors.lastname: Nitendo
authors.forename: Verena
authors.initials: V
authors.lastname: Deserno
authors.forename: Umar
authors.initials: U
authors.lastname: Adamu
authors.forename: Mohammed
authors.initials: M
authors.lastname: Almalla
authors.forename: Rüdiger
authors.initials: R
authors.lastname: Blindt
authors.forename: Felix
authors.initials: F
authors.lastname: Vogt
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003326:Coronary Circulation; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008670:Metals; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D011474:Prosthesis Design; D012008:Recurrence; D012501:Saphenous Vein / Q000637:transplantation*; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency
chemical_list: D008670:Metals