Percutaneous transluminal angioplasty of stenotic coronary artery bypass grafts: 5 years' experience.

In a 60 month period (January 1981 to December 1985), 82 patients (79% male with a mean age of 60 years) had 83 saphenous vein grafts and 5 internal mammary artery grafts with a total of 101 stenotic sites treated with percutaneous transluminal coronary angioplasty. The mean time between bypass surgery and angioplasty was 51.2 months. The procedure was technically successful in 85% of patients, 86% of grafts and 85% of the sites attempted. In these cases, the mean diameter stenosis was reduced from 77 +/- 14 to 27 +/- 20% (p less than 0.001), the mean pressure gradient from 49 +/- 16 to 7 +/- 6 mm Hg (p less than 0.001). Emergency coronary artery bypass graft surgery was necessary in one patient (1.2%) whereas myocardial infarction occurred in three patients (3.6%). There were no hospital deaths. Clinical follow-up was obtained in all 82 patients. Before angioplasty, 23% were in Canadian Cardiovascular Society functional class II, 60% in class III and 17% in class IV. With a mean clinical follow-up period of 21.4 +/- 2.3 months, 71% are in class I, 17% in class II and 12% in class III. There were two deaths, 3 months or more after angioplasty, one probably due to graft closure. So far, angiographic follow-up (at 7.9 +/- 2.1 months) has been available in 26 patients. Ten patients (with 10 grafts) exhibited graft restenosis; six of them have had second successful repeat angioplasty. Among the many variables analyzed, statistically significant predictors of success were a higher measured balloon/graft ratio (p less than 0.001), smaller diameter graft (p less than 0.001), and shorter lesion length (p less than 0.01). The only predictor of complication was diffuseness of disease in the graft (p less than 0.05). The statistically significant predictors of recurrence were the residual stenosis after the initial angioplasty (p less than 0.01) and the measured balloon/graft ratio (p less than 0.01). Angioplasty of coronary artery grafts appears to be a feasible and efficacious procedure with a low complication rate. The technique is a satisfactory alternative to repeat surgery in selected patients.

• Publication year

  1987

• Venue

  Journal of the American College of Cardiology

• Publication date

  Unknown publication date

• Fields of study

  Medicine

• Identifiers
  DOI 10.1016/S0735-1097(87)80075-XPMID 2947947
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• Residual stenosis after the initial angioplasty and measured balloon/graft ratio were significant predictors of restenosis, while diffuseness of disease in the graft predicted complications.

  Confidence 0.96

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewAK (4715169a40) review
• Higher measured balloon/graft ratio, smaller graft diameter, and shorter lesion length were significant predictors of procedural success.

  Confidence 0.95

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewAK (4715169a40) review
• Percutaneous transluminal coronary angioplasty of coronary artery bypass graft stenoses was technically successful in most cases and substantially reduced both diameter stenosis and pressure gradient.

  Confidence 0.98

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewAK (4715169a40) review

• balloon/graft ratio

  metric

  The measured ratio comparing the balloon diameter to the graft diameter during angioplasty.

  Aliases: measured balloon/graft ratio

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewAK (4715169a40) review
• coronary artery bypass grafts

  anatomical structures

  Saphenous vein or internal mammary artery grafts used to bypass blocked coronary arteries.

  Aliases: CABG grafts, bypass grafts

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewAK (4715169a40) review
• diffuseness of disease in the graft

  anatomical characteristic, predictor

  The extent to which a bypass graft has widespread or diffuse atherosclerotic involvement.

  Aliases: diffuse graft disease

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewAK (4715169a40) review
• graft restenosis

  outcome, complication

  Recurrent narrowing of a treated bypass graft after an initially successful angioplasty.

  Aliases: restenosis

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewAK (4715169a40) review
• percutaneous transluminal coronary angioplasty

  procedure

  A catheter-based balloon procedure used to widen narrowed coronary vessel segments.

  Aliases: PTCA, angioplasty

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewAK (4715169a40) review
• residual stenosis after initial angioplasty

  metric, predictor

  The remaining narrowing in the treated graft segment after the first angioplasty attempt.

  Aliases: residual stenosis

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewAK (4715169a40) review
• shorter lesion length

  anatomical characteristic, predictor

  A lesion characteristic referring to a shorter treated stenotic segment within the graft.

  Aliases: short lesion length

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewAK (4715169a40) review
• smaller graft diameter

  anatomical characteristic, predictor

  A graft size characteristic referring to narrower bypass grafts treated in the procedure.

  Aliases: smaller diameter graft

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewAK (4715169a40) review
• technical success

  outcome

  The procedure outcome category indicating successful treatment of the targeted stenotic site, graft, or patient.

  Aliases: procedural success

  박진우 (dztg5apj7m) extractionB (s683577b42) reviewAK (4715169a40) review

• Summary: Reoperation for Recurrent Coronary Artery Disease

  1988cited by this paper
• Coronary angioplasty.

  1988cited by this paper
• Aortocoronary saphenous vein bypass grafts.

  1988cited by this paper
• Recurrence after coronary angioplasty.

  1987cited by this paper
• Multiple vessel coronary angioplasty: classification, results, and patterns of restenosis in 494 consecutive patients.

  1987cited by this paper
• Recurrence after coronary angioplasty.

  1987cited by this paper
• Angioplasty for aortocoronary bypass graft stenosis.

  1986cited by this paper
• Effect of inflation pressures on coronary angioplasty balloons.

  1986cited by this paper
• Restenosis after successful coronary angioplasty in patients with single-vessel disease.

  1986cited by this paper
• Balloon angioplasty of coronary bifurcation lesions: the kissing balloon technique.

  1986cited by this paper
• Role of platelets and platelet inhibitors in aortocoronary artery vein-graft disease.

  1986cited by this paper
• Selection of dilatation hardware for PTCA--1985.

  1985cited by this paper
• Percutaneous transluminal coronary angioplasty after previous coronary artery bypass surgery.

  1985cited by this paper
• Digital radiographic assessment of coronary flow reserve

  1985cited by this paper
• Percutaneous angioplasty of stenoses of bypass grafts or of bypass graft anastomotic sites.

  1984cited by this paper
• Effect of dipyridamole and aspirin on late vein-graft patency after coronary bypass operations.

  1984cited by this paper
• The relation of risk factors to the development of atherosclerosis in saphenous-vein bypass grafts and the progression of disease in the native circulation. A study 10 years after aortocoronary bypass surgery.

  1984cited by this paper
• Percutaneous transluminal coronary angioplasty update.

  1984cited by this paper
• Percutaneous transluminal angioplasty of stenosed aortocoronary bypass grafts.

  1984cited by this paper
• Percutaneous transluminal coronary angioplasty in patients with prior coronary artery bypass grafting.

  1984cited by this paper
• Complex coronary angioplasty: multiple coronary dilatations.

  1984cited by this paper
• Restenosis after percutaneous transluminal coronary angioplasty (PTCA): a report from the PTCA Registry of the National Heart, Lung, and Blood Institute.

  1984cited by this paper
• Acute coronary events associated with percutaneous transluminal coronary angioplasty.

  1984cited by this paper
• Distal embolization of a coronary artery bypass graft atheroma during percutaneous transluminal coronary angioplasty.

  1984cited by this paper
• Morphologic observations after percutaneous transluminal balloon angioplasty of early and late aortocoronary saphenous vein bypass grafts.

  1984cited by this paper
• Method for differential staining of plasma proteins (fibrin and 'hyalin'), basement membranes, ring fibers, and collagen after Carnoy fixation.

  1983cited by this paper
• Morphology of saphenous vein-coronary artery bypass grafts: Seven to 116 months after surgery.

  1983cited by this paper
• The role of intra-aortic balloon counterpulsation in patients undergoing percutaneous transluminal coronary angioplasty.

  1983cited by this paper
• Morphology of saphenous vein-coronary artery bypass grafts: Seven to 116 months after surgery.

  1983cited by this paper
• Percutaneous transluminal coronary angioplasty in patients with prior coronary bypass surgery.

  1983cited by this paper
• Transluminal Coronary Angioplasty and Intracoronary Thrombolysis

  1982cited by this paper
• The National Heart, Lung, and Blood Institute Percutaneous Transluminal Coronary Angioplasty Registry: The First 1116 Cases

  1982cited by this paper
• Percutaneous transluminal coronary angioplasty: report from the Registry of the National Heart, Lung, and Blood Institute.

  1982cited by this paper
• Percutaneous transluminal dilation of aortocoronary saphenous vein bypass grafts.

  1981cited by this paper
• Long-term Serial Angiographic Studies After Coronary Artery Bypass Surgery

  1979cited by this paper
• Reoperation for recurrent coronary artery disease: causes, indications, and results in 168 patients.

  1979cited by this paper
• Aortocoronary Saphenous Vein Bypass Grafts: Long-term Patency, Morphology and Blood Flow in Patients with Patent Grafts Early After Surgery

  1979cited by this paper
• Nonoperative dilatation of coronary-artery stenosis: percutaneous transluminal coronary angioplasty.

  1979cited by this paper
• Reoperation for coronary graft failure: clinical and angiographic results in 43 patients.

  1979cited by this paper
• Transluminal dilatation of coronary-artery stenosis.

  1978cited by this paper
• Reoperation for myocardial revascularization

  1978cited by this paper
• Reoperation in symptomatic patients after direct coronary artery revascularization.

  1978cited by this paper
• Long-Term Patency of Saphenous Veins For Coronary Bypass Grafting

  1978cited by this paper
• Long-term anatomic fate of coronary-artery bypass grafts and functional status of patients five years after operation.

  1978cited by this paper
• Results of reoperation for recurrent angina pectoris.

  1977cited by this paper
• Changes in saphenous veins used as aortocoronary bypass grafts.

  1977cited by this paper
• Occlusive changes at the coronary artery--bypass graft anastomosis. Morphologic study of 95 grafts.

  1977cited by this paper
• Accelerated “Atherosclerosis” A Morphologic Study of 97 Saphenous Vein Coronary Artery Bypass Grafts: A Morphologic Study of 97 Saphenous Vein Coronary Artery Bypass Grafts

  1977cited by this paper
• Letter: Grading of angina pectoris.

  1976cited by this paper
• Saphenous vein autograft replacement of severe segmental coronary artery occlusion: operative technique.

  1968cited by this paper
• Mammary artery-coronary artery anastomosis as method of treatment for angina pectoris.

  1967cited by this paper

• Biostability, durability and calcification of cryopreserved human pericardium after rapid glutaraldehyde-stabilization versus multistep ADAPT(R) treatment in a subcutaneous rat model.

  2014cites this paper
• Early and Midterm Major Adverse Cardiac Events in Patient With Saphenous Vein Graft Using Direct Stenting or Embolic Protection

  2014cites this paper
• Early and Midterm Major Adverse Cardiac Events in Patient With Saphenous Vein Graft Using Direct Stenting or Embolic Protection Device Stenting

  2014cites this paper
• Optimal revascularization strategies for percutaneous coronary intervention of distal anastomotic lesions after coronary artery bypass surgery.

  2013cites this paper
• Distal anastomotic lesions after coronary artery bypass surgery: Incidence, pathogenesis, and treatment approach

  2013cites this paper
• Clinical presentations in immune thrombocytopenic purpura.

  2012cites this paper
• Outcomes following PCI in patients with previous CABG

  2011cites this paper
• Saphenous Vein Graft Stenting and Major Adverse Cardiac Events: A Predictive Model Derived From a Pooled Analysis of 3958 Patients

  2008cites this paper
• ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/SCAI Writing Committee to Update 2001 Guidelines for Percutaneous Coronary Intervention).

  2006cites this paper
• ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/SCAI Writing Committee to Update the 2001 Guidelines for Percutaneous Coronary Intervention).

  2006cites this paper
• ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention—summary article: A report of the American college of cardiology/American heart association task force on practice guidelines(ACC/AHA/SCAI writing committee to update the 2001 guidelines for percutaneous coronary intervention)

  2006cites this paper
• Angioplasty of the internal thoracic artery bypass-graft an alternative to reoperation.

  2004cites this paper
• [Role of glycoprotein IIb/IIIa inhibitors in the treatment of degenerated aortocoronary saphenous vein grafts].

  2002cites this paper
• Stellenwert der Glykoprotein IIb/IIIa-Rezeptorantagonisten in der interventionellen Therapie degenerierter aortokoronarer Venenbypässe

  2002cites this paper
• [Strategy for post coronary artery bypass grafting in patients with bypass graft stenosis: comparison of percutaneous transluminal coronary angioplasty for the native coronary artery, internal mammary artery and saphenous vein graft].

  2001cites this paper
• Excimer Laser for Revascularisation of Saphenous Vein Grafts

  2001cites this paper
• Influence of diabetes mellitus on early and late clinical outcomes in saphenous vein graft stenting.

  2000cites this paper
• Assessing a strategy of initial stand-alone extractional atherectomy followed by staged stent placement in degenerated saphenous vein graft lesions.

  2000cites this paper
• Contemporary percutaneous treatment of saphenous vein graft stenosis: immediate and late outcomes.

  2000cites this paper
• Reperfusion therapy in patients with acute myocardial infarction and prior coronary artery bypass graft surgery (National Registry of Myocardial Infarction-2).

  1999cites this paper
• Novel distal occluder washout method for prevention of no‐reflow during stenting of saphenous vein grafts

  1999cites this paper
• Successful direct stent implantation into a marginal branch of the circumflex artery via the right internal mammary artery in a transfemoral approach.

  1999cites this paper
• [PTCA of the LAD via the internal thoracic artery graft with Doppler ultrasonic control of the results: a case report and review of the literature].

  1999cites this paper
• In-hospital and long-term results of stent deployment compared with balloon angioplasty for treatment of narrowing at the saphenous vein graft distal anastomosis site.

  1999cites this paper
• Elective Wiktor GX stenting for symptomatic stenosis in old aortocoronary saphenous vein bypass grafts: the Antwerp experience.

  1999cites this paper
• Results of Saphenous Vein Graft Stent Implantation: Single Center Results from Use of Oversized Balloon Catheters

  1999cites this paper
• Update on Interventions in Saphenous Vein Grafts

  1998cites this paper
• Morphologic comparison of atherosclerotic lesions in native coronary arteries and saphenous vein graphs with intracoronary angioscopy in patients with unstable angina.

  1998cites this paper
• Transluminal extraction catheter for acute myocardial infarction.

  1997cites this paper
• [Limits of revascularization: interventional treatment possibilities in occlusion and restenosis after bypass operation].

  1997cites this paper
• Coronary Stenosis Morphology: Analysis and Implication

  1997cites this paper
• The Short- and Long-Term Outcome of Left Internal Mammary Artery Angioplasty

  1997cites this paper
• Late myocardial ischemic events after saphenous vein graft intervention--importance of initially "nonsignificant" vein graft lesions.

  1997cites this paper
• Coronary artery and saphenous vein graft remodeling: A review of histologic findings after various interventional procedures—part V

  1997cites this paper
• Percutaneous revascularization of an extensively diseased saphenous vein bypass graft with a saphenous vein-covered Palmaz stent.

  1997cites this paper
• Stenosis Morphology and Risk Assessment in Balloon Angioplasty

  1997cites this paper
• Comparison of stenting and balloon angioplasty for narrowings in aortocoronary saphenous vein conduits in place for more than five years.

  1997cites this paper
• Transluminal extraction catheter atherectomy followed by immediate stenting in treatment of saphenous vein grafts.

  1997cites this paper
• Transluminal extraction atherectomy for aortosaphenous vein graft stent restenosis.

  1996cites this paper
• Reduced distal embolization with transluminal extraction atherectomy compared to balloon angioplasty for saphenous vein graft disease.

  1996cites this paper
• Percutaneous transluminal angioplasty of internal mammary arteries in patients with rest angina.

  1996cites this paper
• Coronary angioplasty versus repeat coronary artery bypass grafting for patients with previous bypass surgery.

  1996cites this paper
• Long-term clinical outcome after stent implantation in saphenous vein grafts.

  1996cites this paper
• Three-dimensional intracoronary ultrasound imaging. Methodology and clinical relevance for the assessment of coronary arteries and bypass grafts.

  1996cites this paper
• Percutaneous bailout therapy of a perforated vein graft using a stent-autologous vein patch.

  1996cites this paper
• Coronary artery stenting: indications and cost implications.

  1996cites this paper
• Coronary artery and saphenous vein graft remodeling: A review of histologic findings after various interventional procedures—Part VI

  1996cites this paper
• Recanalization of Chronically Occluded Aortocoronary Saphenous Vein Bypass Grafts With Long-Term, Low Dose Direct Infusion of Urokinase (ROBUST): a serial trial.

  1996cites this paper
• A multicenter, randomized trial of coronary angioplasty versus directional atherectomy for patients with saphenous vein bypass graft lesions. CAVEAT-II Investigators.

  1995cites this paper
• Percutaneous revascularization of ostial saphenous vein graft stenoses.

  1995cites this paper
• Length of hospital stay and complications after percutaneous transluminal coronary angioplasty. Clinical and procedural predictors. Heparin Registry Investigators.

  1995cites this paper
• Clinical markers, management, and long-term follow-up of early ischemia after coronary artery bypass grafting.

  1995cites this paper
• Transluminal extraction catheter for the treatment of diseased saphenous vein grafts: a multicenter experience.

  1995cites this paper
• [PTCA or alternative techniques? Balloon angioplasty remains dominant].

  1995cites this paper
• Immediate results and late outcomes after stent implantation in saphenous vein graft lesions: the multicenter U.S. Palmaz-Schatz stent experience. The Palmaz-Schatz Stent Study Group.

  1995influential citation
• Extraction atherectomy for the recanalization of totally occluded aortocoronary saphenous vein grafts.

  1995cites this paper
• Coronary stenting for treatment of ostial stenoses of native coronary arteries or aortocoronary saphenous venous grafts.

  1995cites this paper
• Initial and subsequent angiographic outcome of percutaneous transluminal angioplasty performed on internal mammary artery grafts.

  1995cites this paper
• Comparative analysis of saphenous vein bypass vs. native coronary artery balloon angioplasty: technical differences and angiographic response.

  1995cites this paper
• Predictors and sequelae of distal embolization during saphenous vein graft intervention from the CAVEAT-II trial. Coronary Angioplasty Versus Excisional Atherectomy Trial.

  1995cites this paper
• Postoperative symptomatic internal thoracic artery stenosis and successful treatment with PTCA.

  1995cites this paper
• Comparison of clinical and angiographic outcomes after saphenous vein graft angioplasty using coronary versus 'biliary' tubular slotted stents.

  1995cites this paper
• Percutaneous Interventions for Significant Narrowing in Saphenous Vein Aortocoronary Conduits

  1995cites this paper
• Current status of percutaneous transluminal coronary angioplasty.

  1994cites this paper
• Clinical significance of distal embolization after transluminal extraction atherectomy in diffusely diseased saphenous vein grafts.

  1994cites this paper
• Angioplasty of large diameter coronary arteries and saphenous vein grafts utilizing modified appropriately large diameter balloon dilatation catheters.

  1994cites this paper
• Coronary Revascularization in Patients with Postoperative Angina.

  1994cites this paper
• The use of Gianturco-Roubin flexible metallic coronary stents in old saphenous vein grafts: in-hospital outcome and 7 day angiographic patency.

  1994cites this paper
• Long-term angiographic and clinical outcome after implantation of balloon-expandable stents in aortocoronary saphenous vein grafts.

  1994cites this paper
• Favourable results of treatment of narrowed saphenous vein grafts with Palmaz-Schatz stent implantation.

  1994cites this paper
• Percutaneous transluminal coronary angioplasty in patients with prior coronary artery bypass grafting: ten years' experience.

  1994cites this paper
• Palmaz-Schatz stenting for treatment of focal vein graft stenosis: immediate results and long-term outcome.

  1994cites this paper
• [Angiography follow-up after transluminal angioplasty of coronary bypass grafts].

  1994cites this paper
• Clinical and angiographic outcome following implantation of the new Less Shortening Wallstent in aortocoronary vein grafts: introduction of a second generation stent in the clinical arena.

  1994cites this paper
• Percutaneous transluminal angioplasty of saphenous vein grafts for medically refractory unstable angina.

  1994cites this paper
• Successful reversal of cardiogenic shock precipitated by saphenous vein graft distal embolization using aspiration thrombectomy.

  1994cites this paper
• Predictors of outcome of percutaneous excimer laser coronary angioplasty of saphenous vein bypass graft lesions. The Percutaneous Excimer Laser Coronary Angioplasty Registry.

  1994cites this paper
• Stent implantation in saphenous vein grafts.

  1994cites this paper
• Intraluminal Stents in Coronary Bypass Grafts

  1994cites this paper
• Clinical experience with stent implantation in the treatment of saphenous vein graft lesions.

  1994cites this paper
• Progresión de la aterosclerosis y evolución de la estenosis residual despues de la angioplastia coronaria: Estudio angiográfico seriado

  1994cites this paper
• Predictors of myocardial infarction after distal embolization of coronary vessels with percutaneous transluminal coronary angioplasty. Experience of 21 consecutive patients with distal embolization.

  1994cites this paper
• Southwestern internal medicine conference: restenosis: the Achilles heel of coronary angioplasty.

  1993cites this paper
• Placement of "biliary" stents in saphenous vein coronary bypass grafts.

  1993cites this paper
• Percutaneous angioscopy of saphenous vein coronary bypass grafts.

  1993cites this paper
• Balloon angioplasty for the treatment of lesions in saphenous vein bypass grafts.

  1993cites this paper
• Restenosis: The Achilles Heel of Coronary Angioplasty

  1993cites this paper
• "Hugging balloon" dilatation: modification and limitation of the technique in oversized vessels.

  1993cites this paper
• Percutaneous angioplasty of stenosed gastroepiploic artery grafts.

  1993cites this paper
• New treatment approach for chronic total occlusions of saphenous vein grafts: thrombolysis and intravascular stents.

  1993cites this paper
• Comparison of results of coronary angioplasty during acute myocardial infarction with and without previous coronary bypass surgery.

  1993cites this paper
• The impact of balloon angioplasty of coronary artery and/or vein bypass graft lesion(s) upon the survival of patients > or = 5 years after their last bypass surgery.

  1993cites this paper
• Angiographic predictors of a rise in serum creatine kinase (distal embolization) after balloon angioplasty of saphenous vein coronary artery bypass grafts.

  1993cites this paper
• A new expandable intracoronary tantalum (Strecker) stent: early experimental results and follow-up to twelve months.

  1993cites this paper
• Angioplasty of the septal perforators: acute outcome and long-term clinical efficacy.

  1993cites this paper
• Palmaz-Schatz stent implantation in stenosed saphenous vein grafts: clinical and angiographic follow-up.

  1992cites this paper
• Angioplasty in a child with Kawasaki disease.

  1992cites this paper
• Angiographic follow-up after internal mammary artery graft angioplasty.

  1992cites this paper
• Initial and Long‐term Outcome of 354 Patients After Coronary Balloon Angioplasty of Total Coronary Artery Occlusions

  1992cites this paper
• Coronary Angioplasty in Patients with Previous Coronary Artery Bypass Grafting

  1992cites this paper