دورية أكاديمية
Saphenous Vein Graft Disease Interventions
| العنوان: | Saphenous Vein Graft Disease Interventions |
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| المؤلفون: | Sarita Rao, K. Roshan Rao, Achukatla Kumar |
| المصدر: | Indian Journal of Cardiovascular Disease in Women, Vol 06, Iss 03, Pp 199-208 (2021) |
| بيانات النشر: | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| سنة النشر: | 2021 |
| المجموعة: | Directory of Open Access Journals: DOAJ Articles |
| مصطلحات موضوعية: | saphenous vein graft, percutaneous coronary intervention, distal embolization, no reflow phenomenon, embolic protection device, Surgery, RD1-811 |
| الوصف: | In the current era, coronary artery bypass grafting (CABG) is being increasingly performed using total arterial revascularization or a hybrid procedure of stenting of non-LAD disease and minimal access left internal mammary artery (LIMA) to LAD grafts, in order to minimize the need for vein grafts. Still, we encounter saphenous vein graft (SVG) disease, and it might require PCI, which often presents with unique challenges. The current favored strategy is to attempt PCI of the native coronary, if feasible, especially in long degenerated SVG disease, as it has shown better short- and long-term outcome. PCI is preferred over repeat CABG for early recurrent symptoms after CABG in patent LIMA graft and amenable anatomy patients. Balloon predilatation is not recommended unless delivery of an EPD or stent is not possible. Distal protection should be considered the standard of care for percutaneous coronary intervention (PCI) in most patients with older vein grafts, as periprocedural myocardial infarction and no reflow are the Achilles heel of SVG PCI. Intragraft vasodilators should be used liberally, even before balloon angioplasty/stenting. Avoid postdilatation, and usage of undersized but a longer stent length to reduce plaque extrusion through stent struts is preferred. Consider thrombectomy in lesions with a heavy thrombus burden. Keep activated clotting time on the higher side than in conventional PCI. Prolonged dual antiplatelet therapy (DAPT) based on the DAPT score is recommended. With all the precautions and care, we still need a fair wind in our favor to sail through the vein grafts disease. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 2455-7854 |
| العلاقة: | https://doaj.org/toc/2455-7854Test; https://doaj.org/article/5c36459b19014352a8eae037168f6f3cTest |
| DOI: | 10.1055/s-0041-1736323 |
| الإتاحة: | https://doi.org/10.1055/s-0041-1736323Test https://doaj.org/article/5c36459b19014352a8eae037168f6f3cTest |
| رقم الانضمام: | edsbas.84386485 |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 24557854 |
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| DOI: | 10.1055/s-0041-1736323 |