Saphenous vein graft disease treated with the Wiktor Hepamed stent: procedural outcome, in-hospital complications and six-month angiographic follow-up.
OBJECTIVE
To evaluate the effectiveness of electively placed heparin-coated stents in the treatment of coronary saphenous vein bypass grafts with de novo lesions less than 15 mm in diameter in a prospective study with all eligible consecutive patients presenting to Middelheim Hospital, Antwerp, Belgium between September 1997 and August 1998.


METHODS
Fifty patients with 53 lesions were studied. Anginal class, risk factors, quantitative coronary angiographic measurements pre- and postprocedure, procedural outcome, in-hospital events, clinical status on discharge, and six-month clinical and angiographic follow-up (in 48 patients) were recorded. All patients received acetylsalicylic acid and ticlopidine, unless known intolerance was present.


RESULTS
On average, 1.1 stents/patient were placed in very old saphenous vein grafts (11. 7+/-3.9 years). Procedural success was 98%. Only two non-Q wave myocardial infarctions (MIs) occurred, with no Q-wave MIs and no deaths during hospital stay. Length of hospital stay was short (2. 4+/-1.7 days), and 96% of patients were free of angina on discharge. At six-months' follow-up, two patients had died, one of whom died of a noncardiac cause. One patient suffered a non-Q wave MI. At six months, 86% of patients were free from angina. Minimal luminal diameter decreased from 1.14 mm before to 3.33 mm after stenting and to 2.52 mm at six months. Restenosis was present in 22% of patients (21.6% of lesions).


CONCLUSIONS
In a selected population with coronary saphenous vein bypass graft disease, Wiktor heparin-coated stents can be delivered with an excellent periprocedural outcome. Six-month outcome appears favourable with a low recurrence of angina (18%) and a low rate of angiographic restenosis (21.6%).
Van Langenhove
G
G
Cardiology Department, Middelheim Hospital, Antwerp, Belgium. gvanlangenhove@hotmail.com
Vermeersch
P
P
Serrano
P
P
Kutryk
M J
MJ
Stockman
D
D
Convens
C
C
Van den Branden
F
F
Vanagt
E
E
Albertal
M
M
Van den Heuvel
P
P
D000368:Aged; D001241:Aspirin / Q000627:therapeutic use; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000628:therapy*; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D012008:Recurrence; D012501:Saphenous Vein / Q000637:transplantation*; D015607:Stents / Q000009:adverse effects; D013988:Ticlopidine / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
D005343:Fibrinolytic Agents; D006493:Heparin; D013988:Ticlopidine; D001241:Aspirin