factors associated with the no-reflow phenomenon following percutaneous intervention of saphenous vein coronary bypass grafts

Background:we investigated clinical and procedural factors associated with the no-reflow phenomenon following percutaneous coronary intervention (pci) of the saphenous-vein grafts (svg).methods:a cross-sectional study was done on patients who had undergone pci of the svg. patients’ medical documents were reviewed for demographic, clinical, laboratory, and procedural data. slow/no-reflow was defined based on the thrombolysis in myocardial infarction (timi) grade (0 to 2). univariate and multiple logistic regressionanalyses were performed to investigate factors associated with slow/no-reflow and p < 0.050 was considered as significant.results:a total of 205 patients were studied (81% man,mean ± standard deviation of age was 66.8 ± 9.6 years). slow/no-reflow was found in 38 (18.5%) patients. high diastolic blood pressure (p = 0.010), leukocytosis (p = 0.017), diffuse lesions(p = 0.007), degenerated svg (p < 0.001), proximal lesions (p < 0.001), thrombosis (p = 0.013), and lower number of used stents during procedure (p = 0.032) were associated with slow/no-reflow in unadjusted analyses. factors independently associated with slow/no-reflow were pre-procedural high diastolic blood pressure with odds ratio (or) = 3.858 [95% confidence interval(95% ci), 1.157-12.860], degenerated svg with or = 5.901 (95% ci: 1.883-18.492), proximal lesions with or = 5.070 (95% ci: 1.822-14.113), pre-intervention timi grade with or = 0.618 (95% ci: 0.405-0.942), number of used stents for pci with or = 0.074 (95% ci: 0.011-0.481) for > 1 stent, and length of stents used for pci with or = 0.100 (95% ci: 0.019-0.529) for > 30 mm stents.conclusion:this study on the clinical and procedural factors associated with the slow/no-reflow phenomenon following pci of the svg can be used in risk estimation of this serious complication and tailoring preventive strategies to at-risk patients.