Total Endovascular Reconstruction of Occluded Saphenous Vein Grafts Using Coronary or Peripheral Wallstents.

Degeneration of saphenous vein grafts (SVG) resulting in severe stenosis and, ultimately, occlusion is common. Re-do bypass grafting is less successful than the original operation. Intervention with balloon angioplasty alone has poor long-term results, and although improved long-term benefit has been demonstrated with stenting, most stents are limited by their diameter and length. The self-expanding Wallstent has a number of properties that make it particularly suitable for this purpose. We reviewed 26 patients, mean age 64.9 years, 24 males, who had Wallstents deployed in totally occluded or severely obstructed SVG. Seven patients had total graft occlusion, all patients had severe diffuse graft body disease. The mean length of Wallstent used was 54.1 mm. Routine anti-coagulation protocol was used. There were 2 major initial adverse events and no further in-hospital complications. Mean follow-up was 18.8 months. A total of 3 major late clinical events were identified. We conclude that coronary or peripheral Wallstents should be considered for the management of these patients.