Kostantinis S, Simsek B, Karacsonyi J, Alaswad K, Megaly M, Jaffer F, Khatri J, Poommipanit P, Davies R, Rinfret S, Elbarouni B, Ybarra L, Sheikh A, Toma C, Chandwaney R, Goktekin O, ElGuindy A, Mastrodemos O, Rangan B, Burke MN, and Brilakis E. TCT-128 Saphenous Vein Graft Occlusion Following Native Vessel Chronic Total Occlusion Percutaneous Coronary Intervention. J Am Coll Cardiol 2022; 80(12):B53. Full Text
J Am Coll Cardiol
Background: The practice of occluding patent saphenous vein grafts (SVGs) after successful chronic total occlusion (CTO) percutaneous coronary intervention (PCI) of the native vessel has received limited study.
Methods: We analyzed baseline clinical and angiographic characteristics and procedural outcomes of 51 patients who following successful CTO PCI of the native vessel underwent attempted SVG occlusion between 2015 and 2022 at 14 centers. Results: Mean patient age was 71 ± 8 years and 80% were men. The most common CTO target vessel was the right coronary artery (41%), followed by the left circumflex artery (35%). Retrograde crossing was the successful crossing strategy in 78% (n = 40) and the SVG was the collateral used for all the retrograde cases. Recurrent SVG failure (51%) was the most common reason for treating the native vessel instead of the SVG supplying the same vessel. Coils were used in 71% (n = 36) to occlude the SVG with a mean number of 1.9 ± 1.1 coils, and Amplatzer vascular plugs were used in 29% (n = 15) of the cases. All procedures were technically successful and the SVG was occluded completely (TIMI 0 flow) in 75% (n = 38) of the cases. Follow up was available for 38 patients (75%): during a mean follow up of 312 days, the incidence of target lesion failure was 5.4% (n = 2). There were no other associated periprocedural or in-hospital complications.
Conclusion: SVG occlusion after successful native vessel CTO PCI, is associated with favorable periprocedural and mid-term outcomes.
Categories: CORONARY: Complex and Higher Risk Procedures for Indicated Patients (CHIP)