Percutaneous interventions on arterial conduits.
J Invasive Cardiol
; 13(2): 114-20, 2001 Feb.
Article
in En
| MEDLINE
| ID: mdl-11176020
Because of the extensive use of arterial conduits for coronary surgery and the increased risk of repeat surgery in cases of graft failure, there is a growing interest in percutaneous interventions (PI) for patients with conduit dysfunction. PI on arterial conduits is a challenge for the interventional cardiologist, due to anatomic and functional characteristics of the graft. There are no large-scale multicenter or randomized studies focusing on PI of arterial conduits. Few single-center experiences are available, and all report short-term encouraging results and < 20% restenosis rates. Procedural failures are mainly due to graft tortuosity or length. Spasm is not rarely reported in muscular conduits. Stents are effective for the treatment of ostial disease and in bail-out cases, but should be cautiously used in anastomotic lesions. In patients with patent internal mammary artery, large pectoralis branches are sometimes considered responsible for steal phenomena, but flow diversion is usually trivial and embolization should be accomplished only after careful functional evaluations. PI can safely be performed on arterial grafts, with careful planning and knowledge of conduit pathophysiology.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Angioplasty, Balloon, Coronary
/
Coronary Artery Bypass
/
Coronary Disease
Type of study:
Clinical_trials
Limits:
Humans
Language:
En
Journal:
J Invasive Cardiol
Journal subject:
CARDIOLOGIA
Year:
2001
Document type:
Article
Affiliation country:
Country of publication: