Treatment of saphenous vein graft lesions with drug-eluting stents: immediate and midterm outcome.
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.
Ge
Lei
L
EMO Centro Cuore Columbus, 48 Via M. Buonarroti, 20145 Milan, Italy. info@emocolumbus.it
Iakovou
Ioannis
I
Sangiorgi
Giuseppe M
GM
Chieffo
Alaide
A
Melzi
Gloria
G
Cosgrave
John
J
Montorfano
Matteo
M
Michev
Iassen
I
Airoldi
Flavio
F
Carlino
Mauro
M
Corvaja
Nicola
N
Colombo
Antonio
A
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
D007166:Immunosuppressive Agents; D017239:Paclitaxel; D020123:Sirolimus