Comparative results of transluminal extraction coronary atherectomy in saphenous vein graft lesions with and without thrombus

Mark Dooris, Melissa Hoffmann, Sue Glazier, Nadine Juran, Venu Reddy, Cindy L. Grines, Gregory S. Pavlides, Theodore Schreiber, William W. O'Neill, Robert D. Safian

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Objectives. The purpose of this retrospective study was to compare the results of transluminal extraction coronary atherectomy in saphenous vein graft lesions with and without angiographic thrombus. Background. Percutaneous interventions in lesions with thrombus are associated with reduced procedural success and increased risk of complications. Use of the transluminal extraction catheter, which cuts and aspirates atheroma and thrombus, has been advocated as a potential revascularization strategy for lesions with thrombus. Methods. Baseline patient characteristics, lesion morphology, immediate angiographic results, in-hospital complications and follow-up were prospectively entered into an interventional cardiology data base. The results of transluminal extraction coronary atherectomy in saphenous vein bypass grafts with angiographic thrombus were compared with results in similar grafts without angiographic thrombus. Results. Transluminal extraction coronary atherectomy was performed in 175 patients with 183 vein graft lesions, including 59 lesions (32%) with thrombus (Group 1) and 124 (68%) without thrombus (Group 2). Compared with lesions in Group 2, lesions in Group 1 were associated with a higher incidence of baseline total occlusion, diffuse disease and abnormal Thrombolysis in Myocardial Infarction (TIMI) grade flow (p < 0.05); more severe diameter stenosis at baseline, after atherectomy and after final angiography (p < 0.05); a lower rate of clinical success (69% vs, 88%, p < 0.01); and more angiographic and clinical complications, including no reflow (p < 0.05), vascular repair (p < 0.05) and Q wave myocardial infarction (p = 0.09). Conclusions. In transluminal extraction coronary atherectomy of saphenous vein bypass grafts, the presence of thrombus is associated with more baseline lesion complexity, reduced clinical success and increased risk of no reflow, Q wave myocardial infarction and vascular repair.

Original languageEnglish (US)
Pages (from-to)1700-1705
Number of pages6
JournalJournal of the American College of Cardiology
Volume25
Issue number7
DOIs
StatePublished - Jun 1995

Fingerprint

Coronary Atherectomy
Saphenous Vein
Thrombosis
Transplants
Myocardial Infarction
Blood Vessels
Atherectomy
Atherosclerotic Plaques
Cardiology
Veins
Angiography
Pathologic Constriction
Catheters
Retrospective Studies
Databases

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Comparative results of transluminal extraction coronary atherectomy in saphenous vein graft lesions with and without thrombus. / Dooris, Mark; Hoffmann, Melissa; Glazier, Sue; Juran, Nadine; Reddy, Venu; Grines, Cindy L.; Pavlides, Gregory S.; Schreiber, Theodore; O'Neill, William W.; Safian, Robert D.

In: Journal of the American College of Cardiology, Vol. 25, No. 7, 06.1995, p. 1700-1705.

Research output: Contribution to journalArticle

Dooris, Mark ; Hoffmann, Melissa ; Glazier, Sue ; Juran, Nadine ; Reddy, Venu ; Grines, Cindy L. ; Pavlides, Gregory S. ; Schreiber, Theodore ; O'Neill, William W. ; Safian, Robert D. / Comparative results of transluminal extraction coronary atherectomy in saphenous vein graft lesions with and without thrombus. In: Journal of the American College of Cardiology. 1995 ; Vol. 25, No. 7. pp. 1700-1705.
@article{e36708a8bb034332921f9162a26fd6be,
title = "Comparative results of transluminal extraction coronary atherectomy in saphenous vein graft lesions with and without thrombus",
abstract = "Objectives. The purpose of this retrospective study was to compare the results of transluminal extraction coronary atherectomy in saphenous vein graft lesions with and without angiographic thrombus. Background. Percutaneous interventions in lesions with thrombus are associated with reduced procedural success and increased risk of complications. Use of the transluminal extraction catheter, which cuts and aspirates atheroma and thrombus, has been advocated as a potential revascularization strategy for lesions with thrombus. Methods. Baseline patient characteristics, lesion morphology, immediate angiographic results, in-hospital complications and follow-up were prospectively entered into an interventional cardiology data base. The results of transluminal extraction coronary atherectomy in saphenous vein bypass grafts with angiographic thrombus were compared with results in similar grafts without angiographic thrombus. Results. Transluminal extraction coronary atherectomy was performed in 175 patients with 183 vein graft lesions, including 59 lesions (32{\%}) with thrombus (Group 1) and 124 (68{\%}) without thrombus (Group 2). Compared with lesions in Group 2, lesions in Group 1 were associated with a higher incidence of baseline total occlusion, diffuse disease and abnormal Thrombolysis in Myocardial Infarction (TIMI) grade flow (p < 0.05); more severe diameter stenosis at baseline, after atherectomy and after final angiography (p < 0.05); a lower rate of clinical success (69{\%} vs, 88{\%}, p < 0.01); and more angiographic and clinical complications, including no reflow (p < 0.05), vascular repair (p < 0.05) and Q wave myocardial infarction (p = 0.09). Conclusions. In transluminal extraction coronary atherectomy of saphenous vein bypass grafts, the presence of thrombus is associated with more baseline lesion complexity, reduced clinical success and increased risk of no reflow, Q wave myocardial infarction and vascular repair.",
author = "Mark Dooris and Melissa Hoffmann and Sue Glazier and Nadine Juran and Venu Reddy and Grines, {Cindy L.} and Pavlides, {Gregory S.} and Theodore Schreiber and O'Neill, {William W.} and Safian, {Robert D.}",
year = "1995",
month = "6",
doi = "10.1016/0735-1097(95)00043-4",
language = "English (US)",
volume = "25",
pages = "1700--1705",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "7",

}

TY - JOUR

T1 - Comparative results of transluminal extraction coronary atherectomy in saphenous vein graft lesions with and without thrombus

AU - Dooris, Mark

AU - Hoffmann, Melissa

AU - Glazier, Sue

AU - Juran, Nadine

AU - Reddy, Venu

AU - Grines, Cindy L.

AU - Pavlides, Gregory S.

AU - Schreiber, Theodore

AU - O'Neill, William W.

AU - Safian, Robert D.

PY - 1995/6

Y1 - 1995/6

N2 - Objectives. The purpose of this retrospective study was to compare the results of transluminal extraction coronary atherectomy in saphenous vein graft lesions with and without angiographic thrombus. Background. Percutaneous interventions in lesions with thrombus are associated with reduced procedural success and increased risk of complications. Use of the transluminal extraction catheter, which cuts and aspirates atheroma and thrombus, has been advocated as a potential revascularization strategy for lesions with thrombus. Methods. Baseline patient characteristics, lesion morphology, immediate angiographic results, in-hospital complications and follow-up were prospectively entered into an interventional cardiology data base. The results of transluminal extraction coronary atherectomy in saphenous vein bypass grafts with angiographic thrombus were compared with results in similar grafts without angiographic thrombus. Results. Transluminal extraction coronary atherectomy was performed in 175 patients with 183 vein graft lesions, including 59 lesions (32%) with thrombus (Group 1) and 124 (68%) without thrombus (Group 2). Compared with lesions in Group 2, lesions in Group 1 were associated with a higher incidence of baseline total occlusion, diffuse disease and abnormal Thrombolysis in Myocardial Infarction (TIMI) grade flow (p < 0.05); more severe diameter stenosis at baseline, after atherectomy and after final angiography (p < 0.05); a lower rate of clinical success (69% vs, 88%, p < 0.01); and more angiographic and clinical complications, including no reflow (p < 0.05), vascular repair (p < 0.05) and Q wave myocardial infarction (p = 0.09). Conclusions. In transluminal extraction coronary atherectomy of saphenous vein bypass grafts, the presence of thrombus is associated with more baseline lesion complexity, reduced clinical success and increased risk of no reflow, Q wave myocardial infarction and vascular repair.

AB - Objectives. The purpose of this retrospective study was to compare the results of transluminal extraction coronary atherectomy in saphenous vein graft lesions with and without angiographic thrombus. Background. Percutaneous interventions in lesions with thrombus are associated with reduced procedural success and increased risk of complications. Use of the transluminal extraction catheter, which cuts and aspirates atheroma and thrombus, has been advocated as a potential revascularization strategy for lesions with thrombus. Methods. Baseline patient characteristics, lesion morphology, immediate angiographic results, in-hospital complications and follow-up were prospectively entered into an interventional cardiology data base. The results of transluminal extraction coronary atherectomy in saphenous vein bypass grafts with angiographic thrombus were compared with results in similar grafts without angiographic thrombus. Results. Transluminal extraction coronary atherectomy was performed in 175 patients with 183 vein graft lesions, including 59 lesions (32%) with thrombus (Group 1) and 124 (68%) without thrombus (Group 2). Compared with lesions in Group 2, lesions in Group 1 were associated with a higher incidence of baseline total occlusion, diffuse disease and abnormal Thrombolysis in Myocardial Infarction (TIMI) grade flow (p < 0.05); more severe diameter stenosis at baseline, after atherectomy and after final angiography (p < 0.05); a lower rate of clinical success (69% vs, 88%, p < 0.01); and more angiographic and clinical complications, including no reflow (p < 0.05), vascular repair (p < 0.05) and Q wave myocardial infarction (p = 0.09). Conclusions. In transluminal extraction coronary atherectomy of saphenous vein bypass grafts, the presence of thrombus is associated with more baseline lesion complexity, reduced clinical success and increased risk of no reflow, Q wave myocardial infarction and vascular repair.

UR - http://www.scopus.com/inward/record.url?scp=0029010018&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029010018&partnerID=8YFLogxK

U2 - 10.1016/0735-1097(95)00043-4

DO - 10.1016/0735-1097(95)00043-4

M3 - Article

C2 - 7759726

AN - SCOPUS:0029010018

VL - 25

SP - 1700

EP - 1705

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 7

ER -