Transluminal angioplasty after surgical revascularization.

Revascularization has become an established way of treating coronary heart disease. Progression of the disease, graft failure, and surgical complications may lead to recurrent symptoms in a significant number of patients after surgical revascularization. Transluminal techniques are the preferred way of dealing with the recurrences. Saphenous vein bypass grafts present high recurrence rates when submitted to percutaneous transluminal coronary angioplasty alone; the restenosis rate of stenoses in the proximal and mid segment of bypass grafts is more than 50%. Atherectomy has become an established way of treating diseased bypass grafts if the disease is limited to short segments. The best results may currently be obtained by implantation of intraluminal stents, which not only prevent embolization of graft material but also reduce the recurrence rate. Laser techniques may find their role in treatment of diffuse native coronary artery disease, particularly in small-diameter vessels and ostial lesions.