Objective: To evaluate the feasibility and efficacy of percutaneous coronary intervention (PCI) for graft occlusion post coronary artery bypass graft (CABG).
Methods: The clinical data of 135 post-CABG patients with bypass graft occlusion and angina pectoris symptoms admitted to our department between June 2003 and June 2007 were analyzed. The mean interval from CABG to index angiography was 33.8 +/- 23.5 months. Among 318 grafts, 29 left internal mammary artery (LIMA, 29/128, 22.7%) and 117 saphenous vein bypass grafts (117/188, 62.2%) were occluded. A total of 158 target lesions from these 146 vessels were treated with PCI. All target lesions were B2/C type lesion with 29.7% (47/158) chronic total occlusions.
Results: A total of 310 DES were implanted. The total success rate of PCI procedure was 96. 3% (130/135), and lesion success rate was 96.8% (153/158). No major clinical complications occurred during peri-intervention period. All patients underwent PCI were followed at 12 month. Angiographic follow-up was obtained in 89 patients and the angiographic restenosis rate was 5.6% (5/89) in these patients. The major adverse cardiac events and target vessel revascularization rates were 5.4% (7/130) and 6.2% (8/130), respectively.
Conclusion: This study demonstrates that PCI procedure for graft occlusion post-CABG is feasible and safe and associated with a high procedure success rate and favorable long-term clinical and angiographic outcomes.
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JBJS Essent Surg Tech
May 2024
Radboud University Medical Center, Nijmegen, The Netherlands.
Background: This video article describes the use of bone-anchored prostheses for patients with transtibial amputations, most often resulting from trauma, infection, or dysvascular disease. Large studies have shown that about half of all patients with a socket-suspended artificial limb experience limited mobility and limited prosthesis use because of socket-related problems. These problems occur at the socket-residual limb interface as a result of a painful and unstable connection, leading to an asymmetrical gait and subsequent pelvic and back pain.
View Article and Find Full Text PDFJACC Case Rep
January 2025
Section of Cardiovascular Diseases, White River Health, Batesville, Arkansas, USA.
Patients presenting with acute coronary syndrome with ST-segment elevation myocardial infarction require rapid and decisive interventions to restore blood flow to the affected myocardium, minimizing ischemic damage. This case report is particularly unique because it involves a patient presenting with ST-segment elevation myocardial infarction, where the culprit lesion was an occluded coronary artery graft with an extensive thrombus burden. The complexity of this case necessitated a strategic shift to revascularize the chronically occluded native vessel instead of the graft.
View Article and Find Full Text PDFJ Vasc Surg Cases Innov Tech
April 2025
Libin Cardiovascular Institute, University of Calgary, Calgary, Alberta, Canada.
We describe a patient with an asymptomatic infrarenal abdominal aortic aneurysm. Treatment decisions were complicated by the presence of a left congenital pelvic kidney supplied by two renal arteries originating from the proximal common iliac arteries bilaterally and respiratory status that was prohibitive to open repair. A hybrid surgical repair was performed with a bifurcated aortic endograft and parallel grafting to revascularize the pelvic renal arteries.
View Article and Find Full Text PDFJ Vasc Access
January 2025
Department of Vascular Surgery, Helios Klinikum Krefeld, Krefeld, Germany.
A 66-year-old transfeminine patient presented to our institution with a central-venous stenosis causing dysfunction of her arteriovenous (AV) graft on her left arm. The patient was treated repeatedly, because of restenosis. Due to complete occlusion of the graft and subclavian vein as well as a liquid tumor located around the stenotic segment of the vein, we resected the left subclavian vein via a trap-door thoracotomy and inserted a PTFE-graft.
View Article and Find Full Text PDFJ Cardiol
January 2025
Division of Cardiac Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Background: Atrial fibrillation (AF) is a prevalent cardiac arrhythmia that greatly elevates the risk of stroke. This risk increases both during and after cardiac procedures, such as coronary artery bypass grafting (CABG). There is an increasing interest in non-pharmacological treatments such as left atrial appendage occlusion (LAAO) and surgical ablation, intending to enhance both immediate and long-term postoperative results.
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