Risk factors for the development of restenosis following stent implantation of venous bypass grafts.
OBJECTIVE
To analyse the variables involved in the high restenosis rate following stent implantation in coronary artery bypass grafts.


METHODS
A retrospective analysis of a consecutive group of patients attending a tertiary centre.


METHODS
The long term angiographic outcome of 219 stent implantations for individual lesions performed in 191 patients was investigated. Multivariate analysis correlated clinical, procedural, and angiographic variables with the incidence of angiographic restenosis, defined as diameter stenosis > 50% at follow up.


RESULTS
Angiographic restenosis was observed in 34% of lesions treated. Multiple logistic regression analysis defined diabetes mellitus (odds ratio 6.91, 95% confidence interval (CI) 2.43 to 9.69), graft recanalisation (2.89, 95% CI 1.18 to 6.63), lesion at the aortic anastomosis (6.98, 95% CI 2.77 to 21.31), lesion at the coronary anastomosis (3.01, 95% CI 1.19 to 7.69), high diameter stenosis after stent placement (7.21, 95% CI 2.66 to 16.81), placement of long stents (2.73, 95% CI 1.09 to 7.39), and implantation of more than one stent (7.31, 95% CI 2.08 to 19.96) as independent predictors of graft in-stent restenosis.


CONCLUSIONS
There appears to be a specific risk factor constellation contributing to the high restenosis rate following stent implantation in venous bypass grafts. Critical consideration of these variables may help identify patients who are poor candidates for stent implantation and who may benefit from a different approach.
Heidland
U E
UE
School of Internal Medicine, Department of Cardiology, Pneumology and Angiology, Heinrich-Heine-University, Moorenstrasse 5, D-40225 Düsseldorf, Germany. heidland@med.uni-duesseldorf.de
Heintzen
M P
MP
Michel
C J
CJ
Strauer
B E
BE
D000368:Aged; D000704:Analysis of Variance; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000453:epidemiology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents