TY - BOOK AU - Badr, Salem AU - Barbash, Israel M AU - Dvir, Danny AU - Kitabata, Hironori AU - Loh, Joshua P AU - Pichard, Augusto D AU - Torguson, Rebecca AU - Waksman, Ron TI - Optimal revascularization strategies for percutaneous coronary intervention of distal anastomotic lesions after coronary artery bypass surgery SN - 0896-4327 PY - 2013/// KW - *Coronary Artery Bypass/ae [Adverse Effects] KW - *Coronary Restenosis/th [Therapy] KW - *Graft Occlusion, Vascular/th [Therapy] KW - *Percutaneous Coronary Intervention KW - Aged KW - Aged, 80 and over KW - Angioplasty, Balloon, Coronary KW - Coronary Artery Bypass/mt [Methods] KW - Drug-Eluting Stents KW - Female KW - Humans KW - Male KW - Middle Aged KW - Reoperation KW - Retrospective Studies KW - Saphenous Vein/tr [Transplantation] KW - Stents KW - Treatment Outcome KW - Vascular Patency KW - MedStar Heart & Vascular Institute KW - Journal Article N2 - BACKGROUND: Distal anastomotic lesions are the most common reason for venous graft failure especially early after bypass surgery. However, the best percutaneous method for treating these lesions is still controversial; CONCLUSIONS: When selecting the treatment modality for saphenous vein graft distal anastomotic lesions, BMS implantation should be discouraged while POBA and DES implantation can be performed with favorable long-term outcomes. The optimal treatment approach should be evaluated in large, randomized clinical trials. 2013, Wiley Periodicals, Inc; METHODS: All patients from 2/2000 to 1/2011 who underwent percutaneous coronary intervention of bypass graft distal anastomotic lesions were retrospectively enrolled. Among the 139 patients included, 26 (18.7%) were treated with plain old balloon angioplasty (POBA), 68 (48.9%) with bare metal stents (BMS), and 45 (32.4%) with drug-eluting stents (DES); OBJECTIVE: To determine the best revascularization strategy when treating distal anastomotic lesions; RESULTS: Baseline characteristics were generally comparable among the 3 groups. At 6 months' follow-up, the highest rate of target lesion revascularization-major adverse cardiac events (TLR-MACE) was seen in the BMS group compared to the DES and POBA groups (16.2 vs. 2.2 vs. 3.8%, respectively, P=0.03), which was driven mainly by the highest rates of death and TLR in the BMS group (11.8 and 4.7%, respectively). At 1-year follow-up, a higher rate of TLR-MACE was seen in the BMS group compared to the DES and POBA groups (20.6 vs. 11.1 vs. 7.7%, respectively, P=0.19). After adjustment, on Cox regression analysis for hazard ratios, no significant differences were found among the 3 groups at 1-year follow-up of TLR-MACE UR - http://dx.doi.org/10.1111/joic.12042 ER -