TOTAL ENDOVASCULAR RECONSTRUCTION OF OCCLUDED SAPHENOUS-VEIN GRAFTS USING CORONARY OR PERIPHERAL WALLSTENTS

Degeneration of saphenous vein grafts (SVG) resulting in severe stenos is and, ultimately, occlusion is common. Re-do bypass grafting is less successful than the original operation. Intervention with balloon ang ioplasty alone has poor long-term results, and although improved long- term benefit has been demonstrated with stenting, most stents are limi ted by their diameter and length. The self-expanding Wallstent has a n umber of properties that make it particularly suitable for this purpos e. We reviewed 26 patients, mean age 64.9 years, 24 males, who had Wal lstents deployed in totally occluded or severely obstructed SVG. Seven patients had total graft occlusion, all patients had severe diffuse g raft body disease. The mean length of Wallstent used was 54.1 mm. Rout ine anti-coagulation protocol was used. There were 2 major initial adv erse events and no further in-hospital complications. Mean follow-up w as 18.8 months. A total of 3 major late clinical events were identifie d. We conclude that coronary or peripheral Wallstents should be consid ered for the management of these patients.