Percutaneous angioplasty of stenoses of bypass grafts or of bypass graft anastomotic sites.

Forty patients who had stenoses of coronary artery bypass grafts or stenoses of the proximal or distal coronary insertion sites were treated with percutaneous transluminal angioplasty (PTA). PTA was successful in 78% of the patients. Mean stenoses were diminished from 86% to 34% in luminal diameter. One patient needed emergency coronary artery bypass grafting. There were no deaths associated with PTA. Follow-up angiography showed continued patency in asymptomatic patients, whereas in all but 1 patient with recurrent symptoms restenosis had developed at the PTA site. In 38% of patients restenosis developed after successful PTA; the highest restenosis rate was after PTA of aorta/graft anastomoses or proximal graft stenoses. In conclusion, PTA is a successful, low risk alternative to repeat coronary artery bypass grafting, although the restenosis rates at some PTA sites are high.