Covered stent grafts: role in intervention of coronary arteries and degenerated vein grafts.
Covered stent grafts, metal stents covered by a polytetrafluoroethylene (PTFE) membrane, were developed in order to prevent restenosis, which is due to proliferation of tissue through the stent mesh. However, observational studies suggest that the cardiovascular event rate is elevated, when stent grafts are used electively in native vessels. In contrast, stent grafts appeared to be safe in the larger vessels of degenerated vein grafts. Potentially, microembolism of atherosclerotic debris might be reduced when used in saphenous vein grafts. Therefore, a randomized prospective study (STING) was performed to compare conventional stents with stent grafts in this indication. However, preliminary results do not support the hypothesis that stent grafts are superior. Further ongoing studies have to be awaited before a final conclusion can be drawn. Nevertheless, stent grafts are very helpful and reduce cardiovascular event rates and the need to perform emergency surgery in the case of a coronary rupture during a percutaneous intervention. Thus, having a stent graft available in the catheterization laboratory provides the interventionalist an important anchor for bail out situations.
Schächinger
Volker
V
Medizinische Klinik IV Kardiologie J. W. Goethe Universität Frankfurt Theodor-Stern-Kai 7 60590 Frankfurt, Germany. schaechinger@em.uni-frankfurt.de
Zeiher
Andreas M
AM
D015906:Angioplasty, Balloon, Coronary; D020099:Coated Materials, Biocompatible; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D023903:Coronary Restenosis / Q000517:prevention & control*; D004617:Embolism / Q000517:prevention & control; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000517:prevention & control*; D006801:Humans; D011138:Polytetrafluoroethylene; D011446:Prospective Studies; D011474:Prosthesis Design; D016032:Randomized Controlled Trials as Topic; D012501:Saphenous Vein / Q000637:transplantation; D015607:Stents; D013997:Time Factors; D014680:Veins / Q000637:transplantation*
D020099:Coated Materials, Biocompatible; D011138:Polytetrafluoroethylene