Stenting or balloon angioplasty of stenosed autologous saphenous vein grafts in pigs.
In a model of early and aggressive vein graft stenosis in pigs, an intervention was performed with a single stent (n = 12 grafts), multiple stents (n = 6), or balloon angioplasty (n = 6), while grafts with mild stenoses were left untreated (n = 8). Four weeks after intervention, angiography showed that grafts with single stents, balloon angioplasty, or untreated grafts had patency rates of 92%, 83%, and 83%, respectively. Grafts receiving multiple stents, however, showed only a 17% patency rate (p < 0.05). Balloon dilatation or placement of a single stent improved the angiographic minimal diameter by 0.6 +/- 0.2 and 0.8 +/- 0.3 mm, respectively, over the short term, but this gain was lost during the follow-up period. Multiple stents showed a similar gain (0.5 +/- 0.2 mm) but more loss occurred during the follow-up period (2.4 +/- 0.2 mm). Histology revealed no significant differences between the treatment groups except for the prolonged presence of thrombus remnants in association with the stent wires. In conclusion, single stents and balloon angioplasty show good patency in early saphenous vein graft narrowing but multiple stents show a high occlusion rate.
van Beusekom
H M
HM
Department of Cardiology, Erasmus University Rotterdam, The Netherlands.
Serruys
P W
PW
Post
J C
JC
Verdouw
P D
PD
van der Giessen
W J
WJ
D000714:Anastomosis, Surgical; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D000818:Animals; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000473:pathology / Q000601:surgery; D004730:Endothelium, Vascular / Q000473:pathology; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D007150:Immunohistochemistry; D008264:Macrophages / Q000473:pathology; D009131:Muscle, Smooth, Vascular / Q000473:pathology; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000473:pathology / Q000637:transplantation*; D015607:Stents; D013552:Swine; D014182:Transplantation, Autologous; D014654:Vascular Patency