Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Sep 26, 2021; 13(9): 493-502
Published online Sep 26, 2021. doi: 10.4330/wjc.v13.i9.493
Percutaneous coronary intervention of totally occluded coronary venous bypass grafts: An exercise in futility?
Evan W Nardone, Brandon M Madsen, Melissa M McCarey, David L Fischman, Nicholas J Ruggiero, Paul Walinsky, Alec Vishnevsky, Michael P Savage
Evan W Nardone, David L Fischman, Nicholas J Ruggiero, Paul Walinsky, Alec Vishnevsky, Michael P Savage, Department of Medicine, Thomas Jefferson University, Philadelphia, PA 19107, United States
Brandon M Madsen, Department of Anesthesiology, Medstar Georgetown University Hospital, Washington, DC 20007, United States
Melissa M McCarey, Jefferson Clinical Research Institue, Thomas Jefferson University, Philadelphia, PA 19107, United States
Author contributions: Savage MP, Nardone EW, Madsen BM, Fischman DL and McCarey MM contributed to the design of the research study; Savage MP, Fischman DL, Walinsky P, Ruggiero NJ, and Vishnevsky A acquired the data and conducted the procedures. Nardone EW, Madsen BM, Savage MP and Melissa McCarey performed the research. Savage MP, Nardone EW, Melissa McCarey, Fischman DL, Madsen BM, Ruggiero NJ, Walinsky P, and Vishnevsky A analyzed the data and wrote or revised the manuscript; all authors read and approve the final manuscript.
Institutional review board statement: The retrospective saphenous vein graft study was approved by the IRB at Thomas Jefferson University.
Informed consent statement: This was a retrospective study which did not require written consent.
Conflict-of-interest statement: All authors have no conflicts of interest.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at Consent was not obtained but the presented data are anonymized and risk of identification is low.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Michael P Savage, FACC, FACP, MD, Director, Professor, Department of Medicine, Thomas Jefferson University, 111 South 11th Street, Philadelphia, PA 19107, United States.
Received: March 23, 2021
Peer-review started: March 24, 2021
First decision: May 5, 2021
Revised: May 27, 2021
Accepted: July 27, 2021
Article in press: July 27, 2021
Published online: September 26, 2021
Core Tip

Core Tip: Cardiovascular guidelines give a Class III recommendation against performing percutaneous coronary intervention (PCI) on chronically occluded saphenous vein grafts (SVG). Given contemporary advances in SVG intervention, the goal of this study was to reassess the outcomes of PCI for totally occluded SVG in 35 consecutive patients. PCI was initially successful in 29/35 (83%) SVG occlusions. However, at 3 years only 30% of patients survived without a major cardiac event. Although PCI of totally occluded SVG can be performed with a high procedural success rate, its clinical utility remains limited by poor follow-up outcomes.