title: Contemporary approaches to saphenous vein graft interventions: a survey of 275 interventional cardiologists.
abstract: BACKGROUND
  We sought to examine contemporary practice patterns of saphenous vein graft (SVG) interventions.
  
  
  METHODS
  A link to a 10-item online questionnaire was completed in June 2009 by 275 (7%) of 3,771 US interventional cardiologists surveyed.
  
  
  RESULTS
  Sixty-five percent of the respondents use an embolic protection device (EPD) in >75% of SVG interventions. The main reason for not using an EPD was "anatomic difficulties" (55%), followed by device complexity (20%). Filter-based EPDs were the most widely available, well known, and commonly used EPDs, whereas the Guardwire (Medtronic Vascular) was the least commonly used EPD. The main factors underlying EPD selection were lesion location (83%), familiarity with devices (72%), and SVG diameter (64%). Factors that could increase EPD use included availability of simpler to use devices (63%), and more studies demonstrating benefit from EPD use (37%). Compared with interventionalists who used EPDs in most cases (>75%), those who utilized EPDs less frequently were less likely to be familiar with each EPD and had less EPDs available for use. Many interventionalists (84%) administer intragraft vasodilators during SVG interventions, prefer drug-eluting stents (63%) and administer >12 months antiplatelet therapy poststent implantation.
  
  
  CONCLUSIONS
  During SVG interventions (1) "anatomic difficulties" are the most common reason for not utilizing an EPD; (2) filter-based EPDs are most commonly used; (3) lesion location is the most important factor for EPD selection; (4) availability of simpler to use devices could increase EPD use; and (5) intragraft vasodilators, drug-eluting stents and prolonged antiplatelet therapy are commonly utilized.
authors.affiliation: VA North Texas Healthcare System and University of Texas Southwestern Medical Center, Dallas, Texas, USA.
authors.forename: Arif
authors.initials: A
authors.lastname: Mahmood
authors.forename: Tarif
authors.initials: T
authors.lastname: Khair
authors.forename: Abdul-rahman R
authors.initials: AR
authors.lastname: Abdel-karim
authors.forename: Aristotelis
authors.initials: A
authors.lastname: Papayannis
authors.forename: Hao
authors.initials: H
authors.lastname: Xu
authors.forename: Subhash
authors.initials: S
authors.lastname: Banerjee
authors.forename: Emmanouil S
authors.initials: ES
authors.lastname: Brilakis
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods*; D001291:Attitude of Health Personnel; D002309:Cardiology / Q000592:standards / Q000639:trends; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D003328:Coronary Thrombosis / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D057505:Embolic Protection Devices / Q000706:statistics & numerical data*; D006801:Humans; D010818:Practice Patterns, Physicians'; D011859:Radiography; D015642:Radiology, Interventional; D018570:Risk Assessment; D017751:Safety Management; D012501:Saphenous Vein / Q000637:transplantation*; D015607:Stents; D011795:Surveys and Questionnaires; D014481:United States