Use of Saphenous Vein Bypass Grafts for Retrograde Recanalization of Coronary Chronic Total Occlusions

Insights from a Multicenter Registry

Phuong Khanh J Nguyen-Trong, Khaldoon Alaswad, DImitri Karmpaliotis, William Lombardi, J. Aaron Grantham, Nicholas Lembo, David Kandzari, Aris Karatasakis, Judit Karacsonyi, Barbara A. Danek, Bavana V. Rangan, Michele Roesle, Colby R. Ayers, Craig A. Thompson, Subhash Banerjee, Emmanouil S. Brilakis

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

BACKGROUND: The use of saphenous vein grafts (SVGs) for retrograde native-vessel chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. METHODS: We retrospectively reviewed the medical records and coronary angiograms of retrograde CTO-PCI performed through an SVG at four United States institutions between 2012 and 2013. RESULTS: During the study period, retrograde CTO-PCI was performed in 144 of 572 cases (25.2%) and retrograde CTO-PCI via SVG in 21 patients (14.6% of all retrograde cases). Mean age was 71 ± 7 years and 95.2% of the patients were men. The CTO target vessel was the right coronary (38%), circumflex (38%), and left anterior descending (24%) artery. Mean J-CTO score was 3.5 ± 1.0. The most common reentry technique was reverse controlled antegrade dissection and reentry. Technical and procedural success rates were 86% and 81%, respectively, with retrograde SVG-PCI attempts being successful in 67%. A major adverse cardiac event occurred in 2 patients (1 periprocedural myocardial infarction and 1 tamponade resulting in death). Median contrast volume, fluoroscopy time, and procedure time were 250 mL, 91.6 minutes, and 214 minutes, respectively. Two SVGs were coiled due to competitive flow after CTO recanalization. CONCLUSION: Retrograde native-vessel CTO-PCI via SVG represents a small proportion of retrograde CTO-PCIs and was associated with high technical success rates, but may carry increased risk for complications.

Original languageEnglish (US)
Pages (from-to)218-224
Number of pages7
JournalJournal of Invasive Cardiology
Volume28
Issue number6
StatePublished - Jun 1 2016

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Saphenous Vein
Percutaneous Coronary Intervention
Registries
Transplants
Fluoroscopy
Medical Records
Dissection
Angiography
Arteries
Myocardial Infarction

Keywords

  • Chronic total occlusion
  • Percutaneous coronary intervention
  • Saphenous vein graft

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Use of Saphenous Vein Bypass Grafts for Retrograde Recanalization of Coronary Chronic Total Occlusions : Insights from a Multicenter Registry. / Nguyen-Trong, Phuong Khanh J; Alaswad, Khaldoon; Karmpaliotis, DImitri; Lombardi, William; Grantham, J. Aaron; Lembo, Nicholas; Kandzari, David; Karatasakis, Aris; Karacsonyi, Judit; Danek, Barbara A.; Rangan, Bavana V.; Roesle, Michele; Ayers, Colby R.; Thompson, Craig A.; Banerjee, Subhash; Brilakis, Emmanouil S.

In: Journal of Invasive Cardiology, Vol. 28, No. 6, 01.06.2016, p. 218-224.

Research output: Contribution to journalArticle

Nguyen-Trong, PKJ, Alaswad, K, Karmpaliotis, DI, Lombardi, W, Grantham, JA, Lembo, N, Kandzari, D, Karatasakis, A, Karacsonyi, J, Danek, BA, Rangan, BV, Roesle, M, Ayers, CR, Thompson, CA, Banerjee, S & Brilakis, ES 2016, 'Use of Saphenous Vein Bypass Grafts for Retrograde Recanalization of Coronary Chronic Total Occlusions: Insights from a Multicenter Registry', Journal of Invasive Cardiology, vol. 28, no. 6, pp. 218-224.
Nguyen-Trong PKJ, Alaswad K, Karmpaliotis DI, Lombardi W, Grantham JA, Lembo N et al. Use of Saphenous Vein Bypass Grafts for Retrograde Recanalization of Coronary Chronic Total Occlusions: Insights from a Multicenter Registry. Journal of Invasive Cardiology. 2016 Jun 1;28(6):218-224.
Nguyen-Trong, Phuong Khanh J ; Alaswad, Khaldoon ; Karmpaliotis, DImitri ; Lombardi, William ; Grantham, J. Aaron ; Lembo, Nicholas ; Kandzari, David ; Karatasakis, Aris ; Karacsonyi, Judit ; Danek, Barbara A. ; Rangan, Bavana V. ; Roesle, Michele ; Ayers, Colby R. ; Thompson, Craig A. ; Banerjee, Subhash ; Brilakis, Emmanouil S. / Use of Saphenous Vein Bypass Grafts for Retrograde Recanalization of Coronary Chronic Total Occlusions : Insights from a Multicenter Registry. In: Journal of Invasive Cardiology. 2016 ; Vol. 28, No. 6. pp. 218-224.
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abstract = "BACKGROUND: The use of saphenous vein grafts (SVGs) for retrograde native-vessel chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. METHODS: We retrospectively reviewed the medical records and coronary angiograms of retrograde CTO-PCI performed through an SVG at four United States institutions between 2012 and 2013. RESULTS: During the study period, retrograde CTO-PCI was performed in 144 of 572 cases (25.2{\%}) and retrograde CTO-PCI via SVG in 21 patients (14.6{\%} of all retrograde cases). Mean age was 71 ± 7 years and 95.2{\%} of the patients were men. The CTO target vessel was the right coronary (38{\%}), circumflex (38{\%}), and left anterior descending (24{\%}) artery. Mean J-CTO score was 3.5 ± 1.0. The most common reentry technique was reverse controlled antegrade dissection and reentry. Technical and procedural success rates were 86{\%} and 81{\%}, respectively, with retrograde SVG-PCI attempts being successful in 67{\%}. A major adverse cardiac event occurred in 2 patients (1 periprocedural myocardial infarction and 1 tamponade resulting in death). Median contrast volume, fluoroscopy time, and procedure time were 250 mL, 91.6 minutes, and 214 minutes, respectively. Two SVGs were coiled due to competitive flow after CTO recanalization. CONCLUSION: Retrograde native-vessel CTO-PCI via SVG represents a small proportion of retrograde CTO-PCIs and was associated with high technical success rates, but may carry increased risk for complications.",
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AU - Alaswad, Khaldoon

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AU - Lombardi, William

AU - Grantham, J. Aaron

AU - Lembo, Nicholas

AU - Kandzari, David

AU - Karatasakis, Aris

AU - Karacsonyi, Judit

AU - Danek, Barbara A.

AU - Rangan, Bavana V.

AU - Roesle, Michele

AU - Ayers, Colby R.

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AU - Banerjee, Subhash

AU - Brilakis, Emmanouil S.

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N2 - BACKGROUND: The use of saphenous vein grafts (SVGs) for retrograde native-vessel chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. METHODS: We retrospectively reviewed the medical records and coronary angiograms of retrograde CTO-PCI performed through an SVG at four United States institutions between 2012 and 2013. RESULTS: During the study period, retrograde CTO-PCI was performed in 144 of 572 cases (25.2%) and retrograde CTO-PCI via SVG in 21 patients (14.6% of all retrograde cases). Mean age was 71 ± 7 years and 95.2% of the patients were men. The CTO target vessel was the right coronary (38%), circumflex (38%), and left anterior descending (24%) artery. Mean J-CTO score was 3.5 ± 1.0. The most common reentry technique was reverse controlled antegrade dissection and reentry. Technical and procedural success rates were 86% and 81%, respectively, with retrograde SVG-PCI attempts being successful in 67%. A major adverse cardiac event occurred in 2 patients (1 periprocedural myocardial infarction and 1 tamponade resulting in death). Median contrast volume, fluoroscopy time, and procedure time were 250 mL, 91.6 minutes, and 214 minutes, respectively. Two SVGs were coiled due to competitive flow after CTO recanalization. CONCLUSION: Retrograde native-vessel CTO-PCI via SVG represents a small proportion of retrograde CTO-PCIs and was associated with high technical success rates, but may carry increased risk for complications.

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KW - Percutaneous coronary intervention

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