TY - JOUR
T1 - Contemporary approaches to saphenous vein graft interventions
T2 - A survey of 275 interventional cardiologists
AU - Mahmood, Arif
AU - Khair, Tarif
AU - Abdel-karim, Abdul Rahman R
AU - Papayannis, Aristotelis
AU - Xu, Hao
AU - Banerjee, Subhash
AU - Brilakis, Emmanouil S
PY - 2012/4/1
Y1 - 2012/4/1
N2 - Background: We sought to examine contemporary practice patterns of saphenous vein graft (SVG) interventions. Methods: A link to a 10-item online questionnaire was completed in June 2009 by 275 (7%) of 3,771 US interventional cardiologists surveyed. Results: Sixty-five percent of the respondents use an embolic protection device (EPD) in >75% of SVG interventions. The main reason for not using an EPD was "anatomic difficulties" (55%), followed by device complexity (20%). Filter-based EPDs were the most widely available, well known, and commonly used EPDs, whereas the Guardwire (Medtronic Vascular) was the least commonly used EPD. The main factors underlying EPD selection were lesion location (83%), familiarity with devices (72%), and SVG diameter (64%). Factors that could increase EPD use included availability of simpler to use devices (63%), and more studies demonstrating benefit from EPD use (37%). Compared with interventionalists who used EPDs in most cases (>75%), those who utilized EPDs less frequently were less likely to be familiar with each EPD and had less EPDs available for use. Many interventionalists (84%) administer intragraft vasodilators during SVG interventions, prefer drug-eluting stents (63%) and administer >12 months antiplatelet therapy poststent implantation.Conclusions: During SVG interventions (1) "anatomic difficulties" are the most common reason for not utilizing an EPD; (2) filterbased EPDs are most commonly used; (3) lesion location is the most important factor for EPD selection; (4) availability of simpler to use devices could increase EPD use; and (5) intragraft vasodilators, drug-eluting stents and prolonged antiplatelet therapy are commonly utilized.
AB - Background: We sought to examine contemporary practice patterns of saphenous vein graft (SVG) interventions. Methods: A link to a 10-item online questionnaire was completed in June 2009 by 275 (7%) of 3,771 US interventional cardiologists surveyed. Results: Sixty-five percent of the respondents use an embolic protection device (EPD) in >75% of SVG interventions. The main reason for not using an EPD was "anatomic difficulties" (55%), followed by device complexity (20%). Filter-based EPDs were the most widely available, well known, and commonly used EPDs, whereas the Guardwire (Medtronic Vascular) was the least commonly used EPD. The main factors underlying EPD selection were lesion location (83%), familiarity with devices (72%), and SVG diameter (64%). Factors that could increase EPD use included availability of simpler to use devices (63%), and more studies demonstrating benefit from EPD use (37%). Compared with interventionalists who used EPDs in most cases (>75%), those who utilized EPDs less frequently were less likely to be familiar with each EPD and had less EPDs available for use. Many interventionalists (84%) administer intragraft vasodilators during SVG interventions, prefer drug-eluting stents (63%) and administer >12 months antiplatelet therapy poststent implantation.Conclusions: During SVG interventions (1) "anatomic difficulties" are the most common reason for not utilizing an EPD; (2) filterbased EPDs are most commonly used; (3) lesion location is the most important factor for EPD selection; (4) availability of simpler to use devices could increase EPD use; and (5) intragraft vasodilators, drug-eluting stents and prolonged antiplatelet therapy are commonly utilized.
KW - Embolic protection devices
KW - Percutaneous coronary intervention
KW - Saphenous vein graft interventions
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U2 - 10.1002/ccd.23111
DO - 10.1002/ccd.23111
M3 - Article
C2 - 21538790
AN - SCOPUS:84859439651
SN - 1522-1946
VL - 79
SP - 834
EP - 842
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
IS - 5
ER -