Long-term clinical outcome after endoluminal reconstruction of diffusely degenerated saphenous vein grafts with less-shortening wallstents
Identifieur interne : 001027 ( Istex/Curation ); précédent : 001026; suivant : 001028Long-term clinical outcome after endoluminal reconstruction of diffusely degenerated saphenous vein grafts with less-shortening wallstents
Auteurs : Remi Choussat [France] ; Alexander J. R Black [Australie] ; Irene Bossi [France] ; Thierry Joseph [France] ; Jean Fajadet [France] ; Jean Marco [France]Source :
- Journal of the American College of Cardiology [ 0735-1097 ] ; 2000.
English descriptors
- KwdEn :
- Abciximab, Abciximab therapy, American college, Angina, Angiographic, Angioplasty, August, Balloon angioplasty, CABG, Cabg, Cardiol, Choussat, Clinical outcome, Coll, Coll cardiol, Consecutive patients, Coronary artery, Diameter stenosis, Distal embolization, Embolization, Endoluminal, Endoluminal reconstruction, Focal lesions, Graft, High incidence, Immediate results, Implantation, Infarction, Jacc, Lesion, Lesion length, MI, Major events, Myocardial infarction, Nontarget, Nontarget vessel, PTCA, Percutaneous, Ptca, Restenosis, Restenosis rate, Revascularization, SVG, Saphenous, Saphenous vein, Saphenous vein graft, Saphenous vein grafts, Saphenous vein grafts jacc, Stable angina, Stenosed, Stenosis, Stent, Stent implantation, Stent site, Stenting, Study patients, Success rate, Svgs, TIMI, Target lesion, Target vessel, Target vessel revascularization, Thrombus, Ticlopidine, Transluminal, Univariate analysis, Unstable angina, Vein graft, Vein grafts, Wallstent, Wallstents.
- Teeft :
- Abciximab, Abciximab therapy, American college, Angina, Angiographic, Angioplasty, August, Balloon angioplasty, Cabg, Cardiol, Choussat, Clinical outcome, Coll, Coll cardiol, Consecutive patients, Coronary artery, Diameter stenosis, Distal embolization, Embolization, Endoluminal, Endoluminal reconstruction, Focal lesions, Graft, High incidence, Immediate results, Implantation, Infarction, Jacc, Lesion, Lesion length, Major events, Myocardial infarction, Nontarget, Nontarget vessel, Percutaneous, Ptca, Restenosis, Restenosis rate, Revascularization, Saphenous, Saphenous vein, Saphenous vein graft, Saphenous vein grafts, Saphenous vein grafts jacc, Stable angina, Stenosed, Stenosis, Stent, Stent implantation, Stent site, Stenting, Study patients, Success rate, Svgs, Target lesion, Target vessel, Target vessel revascularization, Thrombus, Ticlopidine, Transluminal, Univariate analysis, Unstable angina, Vein graft, Vein grafts, Wallstent, Wallstents.
Abstract
Abstract: OBJECTIVESThis study was designed to evaluate the immediate and long-term clinical results of patients undergoing endoluminal reconstruction in diffusely degenerated saphenous vein grafts (SVGs) with elective implantation of one or more less-shortening Wallstents.BACKGROUNDThe optimal treatment strategy for patients with diffusely degenerated SVGs is controversial. Endoluminal reconstruction by stent implantation is one proposed strategy; however, there are few data regarding long-term clinical outcome.METHODSBetween May 1995 and September 1998, 6,534 consecutive patients underwent angioplasty in our institution, including 440 who were treated for SVG lesions. Of these, 126 (115 men, 11 women, median age 69.5 years, range: 33–86 years) with old SVGs (mean age: 13 ± 5 years) diffusely degenerated stenosed or occluded (mean lesion length: 27 ± 12 mm) were treated electively with implantation of one or multiple (total 197) less-shortening Wallstents.RESULTSBefore discharge, 13 patients (10.3%) sustained at least one major cardiovascular event, including 4 deaths (3.2%), 11 myocardial infarctions (MI) (8.7%), and 3 repeat revascularizations (target vessel = 1, nontarget vessel = 2, 2.4%). Surviving patients were followed for 22 ± 11 months: 13 patients (11.1%) died, 11 (9.4%) sustained an MI, 37 underwent angioplasty (31.6%), and 4 (3.4%) underwent bypass surgery. The estimated three-year event-free survival rates (freedom from death, and freedom from death/MI/target vessel revascularization) were (mean ± SE) 81.1 ± 7.8% and 43.2 ± 18.5%, respectively.CONCLUSIONSThe long-term clinical outcome of patients undergoing endoluminal reconstruction in diffusely degenerated SVG is relatively poor, mainly because of a high incidence of death or MI and the frequent need for repeat angioplasty. It is unlikely that percutaneous intervention alone will provide a satisfactory or definitive solution for these patients.
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DOI: 10.1016/S0735-1097(00)00724-5
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<front><div type="abstract" xml:lang="en">Abstract: OBJECTIVESThis study was designed to evaluate the immediate and long-term clinical results of patients undergoing endoluminal reconstruction in diffusely degenerated saphenous vein grafts (SVGs) with elective implantation of one or more less-shortening Wallstents.BACKGROUNDThe optimal treatment strategy for patients with diffusely degenerated SVGs is controversial. Endoluminal reconstruction by stent implantation is one proposed strategy; however, there are few data regarding long-term clinical outcome.METHODSBetween May 1995 and September 1998, 6,534 consecutive patients underwent angioplasty in our institution, including 440 who were treated for SVG lesions. Of these, 126 (115 men, 11 women, median age 69.5 years, range: 33–86 years) with old SVGs (mean age: 13 ± 5 years) diffusely degenerated stenosed or occluded (mean lesion length: 27 ± 12 mm) were treated electively with implantation of one or multiple (total 197) less-shortening Wallstents.RESULTSBefore discharge, 13 patients (10.3%) sustained at least one major cardiovascular event, including 4 deaths (3.2%), 11 myocardial infarctions (MI) (8.7%), and 3 repeat revascularizations (target vessel = 1, nontarget vessel = 2, 2.4%). Surviving patients were followed for 22 ± 11 months: 13 patients (11.1%) died, 11 (9.4%) sustained an MI, 37 underwent angioplasty (31.6%), and 4 (3.4%) underwent bypass surgery. The estimated three-year event-free survival rates (freedom from death, and freedom from death/MI/target vessel revascularization) were (mean ± SE) 81.1 ± 7.8% and 43.2 ± 18.5%, respectively.CONCLUSIONSThe long-term clinical outcome of patients undergoing endoluminal reconstruction in diffusely degenerated SVG is relatively poor, mainly because of a high incidence of death or MI and the frequent need for repeat angioplasty. It is unlikely that percutaneous intervention alone will provide a satisfactory or definitive solution for these patients.</div>
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