Rotational Atherectomy Before Stenting in the Body of a Saphenous Vein Graft
International Journal of Cardiovascular and Thoracic Surgery
Volume 5, Issue 1, January 2019, Pages: 1-5
Received: Jan. 20, 2019; Accepted: Feb. 25, 2019; Published: Mar. 16, 2019
Views 70      Downloads 17
Authors
Paul Charbel, Cardiology Division, Department of Medicine, Saint George Hospital, UMC-University of Balamand, Faculty of Medical Sciences, Beirut, Lebanon
Joe Shaffu, Cardiology Division, Department of Medicine, Saint George Hospital, UMC-University of Balamand, Faculty of Medical Sciences, Beirut, Lebanon
Nadine Kaoukabani, Cardiothoracic Anesthesia Division, Anesthesia Department, Saint George Hospital, UMC-University of Balamand, Faculty of Medical Sciences, Beirut, Lebanon
Pierrette Habib, Cardiology Division, Department of Medicine, Saint George Hospital, UMC-University of Balamand, Faculty of Medical Sciences, Beirut, Lebanon
Article Tools
Follow on us
Abstract
Management of stenosis of saphenous vein grafts in Coronary artery bypass graft (CABG) patients remains challenging despite the advance in interventional cardiology techniques. Rotational atherectomy is an adjunctive technique used in certain anatomical conditions in native coronary arteries; its use in saphenous vein graft is still contra-indicated by the manufacturer, and has only been reported in few cases in the literature. We report a case of a calcified, non-dilatable, distal saphenous vein graft to Circumflex lesion in a heart failure patient presenting with Non STEMI. The lesion was just proximal to the anastomosis and could not be crossed. Because of high surgical risk, and against manufacturer guidelines, rotational atherectomy of the lesion was performed and was successful with a very good angiographic result. Rotational atherectomy to facilitate percutaneous interventions in saphenous vein graft lesions is feasible, and could be attempted in experienced centers provided the absence of luminal thrombus or dissection.
Keywords
Rotational Atherectomy, Saphenous Vein Graft, Non STEMI, Percutaneous Coronary Intervention
To cite this article
Paul Charbel, Joe Shaffu, Nadine Kaoukabani, Pierrette Habib, Rotational Atherectomy Before Stenting in the Body of a Saphenous Vein Graft, International Journal of Cardiovascular and Thoracic Surgery. Vol. 5, No. 1, 2019, pp. 1-5. doi: 10.11648/j.ijcts.20190501.11
Copyright
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
[1]
Goldman S, Zadina K, Moritz T, et al. Long term patency of saphenous veins and left internal mammary grafts after coronary artery bypass surgery: results of a department of Veterans Affairs Cooperative Study. J Am Coll Cardiol. 2004; 44: 2149-56.
[2]
Bain DS. Percutaneous treatment of saphenous vein graft disease: the ongoing challenge JACC 2003; 42: 1370-2.
[3]
2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions Circulation. 2011; 124: e574-e651.
[4]
J. R. Cardenas, R. K. Strumpf, and R. R. Heuser. Rotational Atherectomy in Restenotic Lesions at the Distal Saphenous Vein Graft Anastomosis Catheterization and Cardiovascular Diagnosis 3653-57 (1995).
[5]
E. Cavusoglu, A. S. Kini,, J. D. Marmur, and S. K. Sharma. Current Status of Rotational Atherectomy Catheterization and Cardiovascular Interventions 62: 485–498 (2004).
[6]
http://www.bostonscientific.com/Device.bsci?page=ResourceDetail&navRelId=1000.1003&method=DevDetailHCP&id=10081831&resource_type_category_id=1&resource_type_id=91&pageDisclaimer=Disclaimer.ProductPag
[7]
S. Leal, R. Campante Teles, et al. Percutaneous revascularization strategies in saphenous vein graft lesions: Long-term results Rev Port Cardiol. 2012; 31 (1): 11-18.
[8]
Holmes DR Jr, Topol EJ, Califf RM, et al. A multicenter, randomized trial of coronary angioplasty versus directional atherectomy for patients with saphenous vein bypass graft lesions. CAVEAT-II Investigators. Circulation 1995; 91: 1966–1974.
[9]
Jackman J, Hermiller J, Sketch M, Davidson C, Tcheng J, Phillips H, Stack R. Combined rotational and directional atherectomy guided by intravascular ultrasound in an occluded vein graft. Am Heart J 1992; 124: 214–216.
[10]
Baron S, Arthur A. Rotational atherectomy for resistant anastomotic saphenous vein bypass graft stenosis. J Invas Cardiol 1996; 8: 120-122.
[11]
Abhyankar A, Vaidya K, Bernstein L. Rotational atherectomy of calcified ostial saphenous vein graft lesion with long term follow-up: a case report. Int J Cardiol 1995; 52: 11–12.
[12]
Cardenas J, Strumpf R, Heuser R. Rotational atherectomy in restenotic lesions at the distal saphenous vein graft anastomosis. Cathet Cardiovasc Diagn 1995; 36: 53–57.
[13]
Coto H. Intravascular ultrasound-guided rotational atherectomy and stent implant in a previously undilatable saphenous vein graft lesion. J Invasive Cardiol 1998; 10: 451–453.
[14]
Thomas WJ, Cowley MJ, Vetrovec GW, Malloy W, Goudreau E. Effectiveness of rotational atherectomy in aortocoronary saphenous vein grafts. Am J Cardiol 2000; 86: 88–91.
[15]
J. BENREY, M. D., A. MESA, M. D., S. JAIN, M. D., and J. A. GARCIA-GREGORY, M. D Successful Rotational Atherectomy of Mid-Saphenous Vein Graft Lesions. Interven Cardiol 1999; 12: 205-208.
[16]
C. W. Don, MD, I. Palacios, MD, K. Rosenfield, MD Use of Rotational Atherectomy in the Body of a Saphenous Vein Coronary Graft J INVASIVE CARDIOL 2009; 21: E168–E170.
ADDRESS
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
U.S.A.
Tel: (001)347-983-5186