Journal title: long-term outcomes of percutaneous coronary interventions within coronary artery bypass grafts arch med sci 2021; 17 (3): 628¿637 doi: https://doi.Org/10.5114/aoms.2018.75608 a2: average, majority gender, date of publication.If information is provided in the future, a supplemental report will be issued.
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The article is a retrospective study on the long-term outcomes of percutaneous coronary interventions (pcis) within coronary artery bypasses.194 patients after pcis of coronary artery bypasses were enrolled.The spider fx embolic protection was one of the devices used during the procedures.The pci was performed in the saphenous graft to the left anterior descending (lad) artery in 43.9% of patients, the circumflex (cx) artery in 37.7%, the right coronary artery (rca) in 23%, the left/right ima in 4.7% and finally, the saphenous vein jump bypass graft in 4.7% of patients.Two or more bypasses were treated in 6.8% of patients while pci of the second vessel (bypass or native artery) was done in 14.2% of patients.The culprit lesion was located in the proximal segment in 36.5% of cases, medial in 21.8%, distal in 23.5% and unknown location in 18.2% of individuals.Unknown location meant that in the available medical records considering the description of the pci procedure, there was no information regarding which graft segment was treated with angioplasty.Among the thirteen patients in the poba/ failed pci group, stent crossing/deployment was not obtained in eight patients with graft stenosis, of whom there were three patients with stable angina (sa) at admission, seven with non-st-segment elevation myocardial infarction (nstemi) and one with unstable angina (ua).One patient with sa developed mi in the follow-up period, one patient with nstemi died, another had mi and another cerebral stroke.The remaining 4 patients did not have macce.Ineffective opening of the occluded graft caused by thrombus was found in 5 patients.Two of the patients had st-segment elevation myocardial infarction (stemi), one of whom died during the procedure, and another one did not present macce during the follow-up period.Of the remaining three patients, all had nstemi at admission, one of them had mi in the follow-up period, and the others did not develop macce during the follow-up.The overall incidence of periprocedural complications was 29 (14.9%) out of 194 individuals.We noted 6 (3.1%) svg dissections, 20 (10.5%) no-reflows, 1 (0.5%) perforation, 3 (1.6%) cardiac arrests, 2 (1%) acute left ventricle failures demanding intra-aortic balloon pump, 2 (1.1%) acute instent thromboses, 2 (1%) bleedings requiring blood transfusion, 2 (1%) respiratory insufficiencies requiring intubation and mechanical ventilation.Long-term follow-up data were available for 156 (80.4%) patients and were limited to venous grafts, also in patients treated at baseline simultaneously with pci of svg and ima or another native artery.The mean follow-up was 964 ±799.1 days (ranging from 0 to 3,200 days).The study endpoints were observed in 94 (59.7%) individuals from among all patients with completed follow-up.Among study endpoints, we noted 23 (24.2%) patients with tlr, 36 (37.9%) with tvr, 25 (26.3%) individuals with mi, 2 (2.1%) with cabg, 4 (4.2%) with cerebral stroke and 29 (30.5%) deaths.The mean time to the primary study endpoint was 669.9 days (from 0 to 2,307 days).The mean follow-up in patients without observed study endpoints (62 individuals) was 1,326.8 days (from 271 to 3,200 days).
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