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Stenting Closed Bypass Grafts

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Post stories and questions about bypass grafts that closed up and were reopened with angioplasty and stents.

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Current Postings on This Page (19):

• I had coronary vein bypass 2 years ago I feel ok now but was told that when using vein from the leg it usually last up to ten years when that time comes can I have a second surgery or is that too dangerous and you basically just wait to die.
Anthony, Tech, Baltimore, Maryland, USA, January 6, 2021

• Nausea can sometimes be a symptom of Acute Coronary Syndrome (ACS) and, if not diagnosed as such, may be mistaken for gastric upset.
Angioplasty.Org Staff, Angioplasty.Org, November 30, 2014

• My father had bypass at the age of 85 and now recently he had nausea symptom and next day he collapsed and died. The doctor he met gave medicine for gas trouble, which wasn't the case probably. Can you let me know what could be the reason. He had swelling on both hands; but he thought it is do with car driving.
Siva, Ganapathy, Chicago, Illinois, USA, November 29, 2014

• Bowdenfan from Georgia -- Are you saying the stents were placed in the bypass grafts or in the native, original artery that was bypassed? How long ago were the stents placed? In any case, if you are having symptoms, you should see your cardiologist. It may be medication-related, or something else, but the point of all these interventions is to make you feel better. For example, President Bill Clinton started having symptoms after his bypass, went in and they stented his native vessel. The next day he was fund-raising for the Haitian earthquake victims. But these are complex issues and your cardiologist, preferably the one who placed the stents, is the best source for specific help.
Angioplasty.Org Staff, Angioplasty.Org, Jun 10, 2013

• 2 years ago I had 2-vessel bypass surgery. Since then, I have had 3 stents placed in one of the bypass arteries. I still have chest pressure, shortness of breath with minimal exertion, extreme fatigue. Any suggestions?
bowdenfan, Winder, Georgia, USA, June 10, 2013

• It is odd that your CABG grafts were patent for so long and then suddenly started closing up, along with stented arteries also closing up. We assume you are doing everything possible to reduce your risk factors (smoking cessation, diet, exercise, complying with prescription meds, etc.). It is possible for an artery to close up within two months, but we also wonder why all these issues are happening at once?
Angioplasty.Org Staff, Angioplasty.Org, June 9, 2013

• I had a quintuple bypass 16 years ago. In May of last year the grafts started failing. Since then I have been stented 5 times. The next to last time was the beginning of April. Those stents held but now I went back in with chests pains had angioplasty and the surgeon said there were 2 new arteries blocked 80 and 90 percent that were open 2 months ago. Is it possible for an open artery to close in 2 months?
multistented, Hillsboro Beach, Florida, June 7, 2013

• Marty A in L.A. -- Considering that 40% of vein grafts are closed up at ten years, you've done very well. Saphenous vein grafts (SVGs) can be stented, although the prognosis for how well this will work depends on a number of factors. Also you would need a determination as to whether or not the risk/benefit ratio for such a procedure is in your favor (i.e. do you really need this to be done?). We would recommend consulting an interventional cardiologist about the feasibility of stenting the SVGs -- even if it's not indicated yet, it might be comforting to know if it's an option.
Angioplasty.Org Staff, Angioplasty.Org, May 22, 2013

• I had a quad bypass 17 years ago. I just had an angiogram & it showed both mammary bypasses open & the two veins beginning to narrow. Can the veins be stented ?
Marty A., Los Angeles, California, USA, May 22, 2013

• G Goulette in Montana -- read through this topic. Closed up bypass grafts can sometimes be opened with angioplasty and stenting, avoiding a repeat bypass surgery. Also sometimes the native (original) artery that was bypassed can be opened with a stent. For example, this is what happened with President Clinton a couple years ago.
Angioplasty.Org Staff, Angioplasty.Org, March 30, 2012

• I am a 57 year old male who had a quadruple coronary by pass when I was 41. I have had 15 stents put in over the past few years. I quit smoking cigarettes three years ago or I really believe I would be dead. Three years ago after another angiogram I was told by my cardiologist I only had one of my bypass grafts open. I have lots and lots of pain all of the time but was told to wait until I have another major heart attack because if I have another bypass now what will I do when I'm 62. I guess I would rather take my chances with another bypass because my quality of life is poor when I am so limited on average activity. My father died from bypass surgery at the age of 39, so I have out lived him and am grateful for modern medicine. Thanks
G Goulette, patient, Morris, Montana, USA, March 19, 2012

• Angieyork in Georgia -- Not sure what you mean by rejecting the graft. Do you mean that it is closing up?
Angioplasty.Org Staff, Angioplasty.Org, March 11, 2012

• I had a bifemoral bypass in Aug. of last year. They now think I may be rejecting the graft. Can anyone tell me what will happen if that turns out to be the case? Won't the graft have to come out?
Angieyork, Resaca, Georgia, USA, March 10, 2012

• Stenting and bypass is not a cure but often a necessity. However, unless you just want to get back to the same place as just before the procedure you need a plan (prevention) here is two web sites that can help immensely.
Vic, CAD patient (no procedures and hoping), Myrtle Beach South Carolina, USA, March 31, 2008

• Try to do two quick answers. Tom -- sometimes it's not technically possible to open the original native vessels, because of a chronic total occlusion or other anatomical issues -- in your case it WAS possible. MJV -- vein grafts are more susceptible to closing up than the Internal Mammary Artery (IMA) -- but 16 years is a long time for those grafts to be open ("patent") -- why they (or any artery) closes up is still not really known -- when it is we'll be a long way toward conquering coronary artery disease. In any case, it would be a good sign that they lasted so long. And yes, it is possible to have more angioplasties or even a second bypass -- although each case is individual.
Angioplasty.Org Staff, Angioplasty.Org, May 15, 2007

• Thanks very much for this clarification. An angiogram last year showed the graft to be "wide open". In one year it filled in 95% and 70% in two spots. Is that unusual--particularly since it had supposedly been open for 16 years and my cholesterol numbers were good (with vytorin). What can I expect next? Does this mean that given the same conditions it will fill again quickly ? If it does what happens then? Can it be fixed with angioplasty? Or am I likely looking at bypass again? Thanks . My cardiologist is considered to be very good technically--but he is not so good at answering such questions.
MJV, Hawaii, USA, May 11, 2007

• I am curious. Why would stents be used to unblock vein grafts? Why wouldn't the cardiologist stent the original artery blockages instead? (Today cardiologists seem willing to stent almost any blocked artery.) Wouldn't the reopening of an artery be better then reopening a vein graft? I had a LIMA artery graft and a vein graft close after only 4 years, and the cardiologist and heart surgeon rejected the idea of trying to open them. Instead they stented the original blockages.
Tom T., Phoenix, Arizona, USA, May 7, 2007

• MJV -- there has not been much difference shown between the CYPHER and TAXUS stents. And it's not that it's "unsafe" to use these stents in reopening a closed vein graft -- it's that it is technically "off-label". That means the FDA has not specifically approved the device for this use, but also it hasn't restricted physicians from using it this way because no data has shown it to be dangerous. Drug-eluting stents have less restenosis, less reclosure -- something that would be important to avoid in a vein graft. The downside of drug-eluting stents is the need to take dual antiplatelet therapy (Plavix or Ticlid plus aspirin) for a year or more.
Angioplasty.Org Staff, Angioplasty.Org, May 5, 2007

• I just had 4 DES put in in 16 year old grafts--3 in one place. The occlusion was 95% at the distal end of a vein graft and 70% in another place. I was on the table three and a half hours and it was clear that the cardiologist was having trouble getting at the spot and properly implanting the stents. In 2003, it was considered unsafe to stent vein grafts and complex blockages with the Cypher coated stent. The stents used in me were Boston Scientific Taxus Express. Do these stents and improved techniques over the last few years make safe the use of these stents in such situations?
MJV, Hawaii. USA, May 5, 2007













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