Contemporary approaches to saphenous vein graft interventions: A survey of 275 interventional cardiologists

Arif Mahmood, Tarif Khair, Abdul Rahman R Abdel-karim, Aristotelis Papayannis, Hao Xu, Subhash Banerjee, Emmanouil S Brilakis

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)834-842
Number of pages9
JournalCatheterization and Cardiovascular Interventions
Volume79
Issue number5
DOIs
StatePublished - Apr 1 2012

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Embolic Protection Devices
Saphenous Vein
Transplants
Equipment and Supplies
Drug-Eluting Stents
Vasodilator Agents
Surveys and Questionnaires
Cardiologists
Blood Vessels

Keywords

  • Embolic protection devices
  • Percutaneous coronary intervention
  • Saphenous vein graft interventions

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Contemporary approaches to saphenous vein graft interventions : A survey of 275 interventional cardiologists. / Mahmood, Arif; Khair, Tarif; Abdel-karim, Abdul Rahman R; Papayannis, Aristotelis; Xu, Hao; Banerjee, Subhash; Brilakis, Emmanouil S.

In: Catheterization and Cardiovascular Interventions, Vol. 79, No. 5, 01.04.2012, p. 834-842.

Research output: Contribution to journalArticle

Mahmood, Arif ; Khair, Tarif ; Abdel-karim, Abdul Rahman R ; Papayannis, Aristotelis ; Xu, Hao ; Banerjee, Subhash ; Brilakis, Emmanouil S. / Contemporary approaches to saphenous vein graft interventions : A survey of 275 interventional cardiologists. In: Catheterization and Cardiovascular Interventions. 2012 ; Vol. 79, No. 5. pp. 834-842.
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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.

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