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Int J Angiol 2018; 27(03): 144-150
DOI: 10.1055/s-0038-1636937
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Procedural Results and Immediate Outcomes following De Novo Saphenous Venous Graft Interventions

Lalita Nemani
1   Department of Cardiology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
,
Maddury Jyotsna
1   Department of Cardiology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
,
Malleswara Rao D.
1   Department of Cardiology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
› Author Affiliations
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Publication History

Publication Date:
26 March 2018 (online)

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Abstract

Background Distal embolization is the detrimental factor in SVG intervention. There is no specific treatment for it except prevention. Guidelines have endorsed the use of embolic protection devices; however, their use is not without complications, and increases the procedural time and cost for the patient.

The objective of this study is to analyze the procedural results and immediate outcome in de novo SVG stenting.

Methods A retrospective observational study of patients who have undergone SVG-percutaneous coronary intervention at our institute. Baseline clinical, demographic data, intervention details, and in-hospital events are analyzed. Statistical analysis was done using Mini tab version 17. Chi-square testing, odds ratio, and 95% confidence intervals were calculated.

Results The study population included 96 lesions in 80 patients. Average age of the graft was 8.2 ± 4 years. Embolic protection devices were used only in 10%. Angiographic and clinical success was seen in 92.5%. Distal embolization was seen in 7.5%. Drug-eluting stent and shorter stents were associated with lesser distal embolization. Stent length (> 20 mm) proved to be an independent predictor of distal embolization. There was no correlation between distal embolization and age of patient, sex, hypertension, diabetes, and smoking, left ventricular function, age of graft, direct stenting, use of embolic device, and glycoprotein 2b/3a inhibitors.

Conclusion De novo SVG lesions can be stented with a high rate of angiographic and procedural success. Stent length is the only independent predictor of distal embolization. SVG interventions can be safely done in the absence of embolic protection devices irrespective of the graft age.

Keywords

saphenous venous graft - embolic protection device - distal embolization - slow flow - no reflow - periprocedural MI - vein degeneration

Limitation of the study

The limitations typically encountered with retrospective studies are applicable here. No follow-up data are considered to study the restenosis rate which is another limitation of SVG lesions.


 

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