TCT-754 Native Coronary Artery Instead of Saphenous Vein Graft Intervention for Treatment of Significant Saphenous Vein Graft Lesions (NASA Registry)
Recommended Citation
Alexandrou M, Mastrodemos O, Al-Ogaili A, Rangan B, Allana S, Rempakos A, Strepkos D, Carvalho P, Mutlu D, Jalli S, Sandoval Y, Burke M, Brilakis E, Alaswad K. TCT-754 Native Coronary Artery Instead of Saphenous Vein Graft Intervention for Treatment of Significant Saphenous Vein Graft Lesions (NASA Registry). J Am Coll Cardiol 2024; 84(18):B303.
Document Type
Conference Proceeding
Publication Date
10-29-2024
Publication Title
J Am Coll Cardiol
Abstract
Background: The outcomes of native coronary artery percutaneous coronary intervention (PCI) in patients with previous coronary artery bypass graft surgery (CABG) presenting with saphenous vein graft (SVG) failure have received limited study. Methods: We examined the outcomes of 76 PCIs of patients with a de novo SVG lesion causing symptoms and treated with PCI of the corresponding native coronary artery, performed at 2 centers from 2016 to 2024. Results: Mean age of the patients was 72.3 ± 11.1 years; 86.8% were men. The previous SVG graft was more often to the right posterior descending artery (44.9%) or the first obtuse marginal branch (43.6%); 78.2% of the patients had a left internal mammary artery graft. Native vessel chronic total occlusions (CTOs) were treated in 97.4% of the patients. Mean PROGRESS-CTO and J-CTO scores were 1.01 ± 0.95 and 2.84 ± 1.01, respectively. Overall technical success was 98.7%, with 1.3% in-hospital major adverse cardiovascular events (MACE). Follow-up was available for 66 cases (86.84%, median: 359 days; Q1-Q3: 182-366 days). MACE included 12 acute coronary syndrome events, 7 target lesion revascularizations, 2 deaths (of which 1 cardiac). Target vessel failure (TVF) occurred in 10 cases (15.2%). The 1-year Kaplan-Meier estimates were 66.0% (95% CI: 53.5%-81.4%) for MACE-free survival and 79.1% (95% CI: 68.0%-92.0%) for TVF-free survival. Median time to TVF was 163 days (Q1-Q3: 75-220 days). [Formula presented] Conclusions: Native coronary PCI in previous CABG patients with SVG failure is effective with high technical success but patients have high risk of recurrent MACE. Categories: CORONARY: Complex and Higher Risk Procedures for Indicated Patients (CHIP).
Volume
84
Issue
18
First Page
B303
