PERCUTANEOUS REVASCULARIZATION OF LESIONS WITH SAPHENOUS-VEIN GRAFT FAILURE - INFLUENCE OF CHRONIC TOTAL OCCLUSION ON EARLY OUTCOME

The purpose of this study was to evaluate a therapeutic strategy of pe rcutaneous transluminal coronary angioplasty (PTCA) in patients with r ecurrent angina following coronary artery bypass grafting. The study l ooked at 112 branches associated with graft failure, excluding new les ions in the native coronary artery (NCA). Chronic total occlusion (CTO ) was observed in 50% of NCA (56/112) and in 68% of the grafts (76/112 ). Thirty-three branches (29%) showed CTO in both NCA and the graft. T he overall success rate was 86% (96/112). The success rate on NCA was 98% (44/45) in non-CTO, while in CTO it was significantly lower at 62% (18/29). As to grafts, the success rate was 94% (32/34) in non-CTO, w hile it was 50% (2/4) in CTO. These characteristics, with respect to l esion morphology and the prevalence of CTO, exerted an influence on th e selection of the access vessels for revascularization. Early outcome depended on the result of treatment of CTO.