title: Treatment of saphenous vein graft lesions with drug-eluting stents: immediate and midterm outcome.
abstract: OBJECTIVE
  The purpose of the present report was to evaluate clinical and angiographic outcomes of drug-eluting stent (DES) implantation in saphenous vein graft (SVG) lesions.
  
  
  BACKGROUND
  The safety and efficacy of DES implantation for the treatment SVG lesions remains uncertain.
  
  
  METHODS
  We evaluated in-hospital and six-month outcomes in 61 consecutive patients treated with DES in SVG lesions from March 2002 to March 2004 (DES group), as compared to 89 consecutive patients treated with bare-metal stents (BMS) in the 24 months immediately before the introduction of DES (BMS group). Major adverse cardiac events (MACE) including death, myocardial infarction, target lesion revascularization (TLR), and target vessel revascularization (TVR) were recorded in-hospital and at six-month follow-up.
  
  
  RESULTS
  The rate of in-hospital MACE was similar between the two groups (6.6% vs. 5.6%, p = 1.0). Cumulative MACE at six months was 11.5% in the DES group and 28.1% in the BMS group (p = 0.02). The DES group had a significantly lower incidence of in-segment restenosis (10.0% vs. 26.7%, p = 0.03), TLR (3.3% vs. 19.8%, p = 0.003), and TVR (4.9% vs. 23.1%, p = 0.003). By Cox regression analysis, diabetes (hazard ratio [HR]: 3.03; 95% confidence interval [CI]: 1.33 to 6.90; p = 0.008), usage of BMS (HR: 2.53; 95% CI: 1.07 to 5.97; p = 0.03), and age of SVG (HR: 1.10; 95% CI: 1.02 to 1.19; p = 0.02) were identified as predictors of MACE at six-month follow-up.
  
  
  CONCLUSIONS
  Compared to BMS implantation, DES implantation in SVG lesions appears safe with favorable and improved mid-term outcomes.
authors.affiliation: EMO Centro Cuore Columbus, 48 Via M. Buonarroti, 20145 Milan, Italy. info@emocolumbus.it
authors.forename: Lei
authors.initials: L
authors.lastname: Ge
authors.forename: Ioannis
authors.initials: I
authors.lastname: Iakovou
authors.forename: Giuseppe M
authors.initials: GM
authors.lastname: Sangiorgi
authors.forename: Alaide
authors.initials: A
authors.lastname: Chieffo
authors.forename: Gloria
authors.initials: G
authors.lastname: Melzi
authors.forename: John
authors.initials: J
authors.lastname: Cosgrave
authors.forename: Matteo
authors.initials: M
authors.lastname: Montorfano
authors.forename: Iassen
authors.initials: I
authors.lastname: Michev
authors.forename: Flavio
authors.initials: F
authors.lastname: Airoldi
authors.forename: Mauro
authors.initials: M
authors.lastname: Carlino
authors.forename: Nicola
authors.initials: N
authors.lastname: Corvaja
authors.forename: Antonio
authors.initials: A
authors.lastname: Colombo
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007558:Italy / Q000453:epidemiology; D008297:Male; D017239:Paclitaxel / Q000008:administration & dosage; D011183:Postoperative Complications / Q000401:mortality; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000637:transplantation*; D020123:Sirolimus / Q000008:administration & dosage; D015607:Stents; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D017239:Paclitaxel; D020123:Sirolimus