title: Long term outcomes of saphaneous vein graft intervention in elderly patients with prior coronary artery bypass graft.
abstract: OBJECTIVE
  To investigate the procedure characteristics and long term follow-up of percutaneous coronary intervention (PCI) for saphaneous vein graft (SVG) lesions in the elderly patients.
  
  
  METHODS
  From December 2005 to December 2011, 84 graft lesions were treated percutaneously. Seventeen were located at proximal anastomosis, 48 were located at SVG body, 19 were located at distal anastomosis. Primary endpoint was defined as major adverse cardiovascular events (MACE, composite of cardiac death, target vessel revascularization, acute myocardial infarction).
  
  
  RESULTS
  The graft age was 6.7 ± 4.0 years. Most anastomosis lesions (80.0%) presented within one year post coronary artery bypass grafting (CABG). Proximal anastomosis lesion had the lowest successful rate for PCI compared with graft body and distal anastomosis lesions (70.6% vs. 91.7%, 79.0%, P < 0.05). The distal embolic protection device was used in 19.1% of patients, most frequently used in body graft PCI (29.2%, P < 0.01). The diameter of the stent was smallest in distal anastomosis group (2.9 ± 0.4 mm, P < 0.05). The highest post dilatation pressure was required in the proximal anastomosis (17.8 ± 2.7 atm, P < 0.05). The patients were followed up for 24.3 ± 16.9 months. MACE occurred in 18.57% of patients. Incidence of MACE was highest among proximal anastomosis PCI (47.1% vs. body graft PCI 16.7%, distal anastomosis PCI 21.1%; P < 0.05). Old myocardial infarction was the predictive factor for the poor clinical outcomes (P = 0.04).
  
  
  CONCLUSIONS
  PCI of SVG lesions is feasible with lower success rate. PCI of ostial graft anastomosis lesions had the lowest procedure success rate and highest MACE rate compared with graft body and distal anastomosis lesions. Old myocardial infarction was a predictive factor of poor outcomes.
authors.affiliation: Department of Cardiology, Beijing An-Zhen Hospital, Capital Medical University, Beijing 100029, China ; Department of Cardiology, Beijing Ji-Shui-Tan Hospital, the 4th Clinical College of Peking University Health Science Center, Beijing 100035, China.
authors.forename: Ji-Hong
authors.initials: JH
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Beijing An-Zhen Hospital, Capital Medical University, Beijing 100029, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Liu
authors.affiliation: Department of Cardiology, Beijing An-Zhen Hospital, Capital Medical University, Beijing 100029, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Du
authors.affiliation: Department of Cardiology, Beijing An-Zhen Hospital, Capital Medical University, Beijing 100029, China.
authors.forename: Chang-Sheng
authors.initials: CS
authors.lastname: Ma
authors.affiliation: Department of Cardiology, Beijing An-Zhen Hospital, Capital Medical University, Beijing 100029, China.
authors.forename: Xue-Si
authors.initials: XS
authors.lastname: Wu
keywords: Anastomosis; Coronary artery bypass grafting; Graft; Percutaneous coronary intervention
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