title: Clinical outcomes after sirolimus-eluting stent implantation for de novo saphenous vein graft lesions.
abstract: The purpose of this study was to evaluate the clinical outcome of patients undergoing sirolimus-eluting stent implantation for de novo lesions within saphenous vein grafts (SVGs). Although the incidence of restenosis following sirolimus-eluting stenting (SES) of native coronary arteries is low, the efficacy of SES to treat de novo lesions within SVGs has not been well studied. A total of 35 patients underwent SES implantation of 39 lesions during 36 procedures. All patients had a minimum follow-up of 6 months following the index procedure. The mean bypass graft age was 10.1 +/- 6.5 years (range, 0-23 years). In-hospital major adverse cardiac events [death, myocardial infarction, thrombosis, or target vessel revascularization (TVR)] occurred in four patients (11%). Clinical follow-up was obtained in 100% of patients (mean follow-up, 7.5 +/- 2.2 months). There was one cardiac death, presumed due to stent thrombosis. TVR occurred in only two patients (6%). Myocardial infarction (MI) occurred in four patients (11%), all attributable to a nontarget vessel. The combined endpoint of death, MI, or TVR occurred in seven patients (20%). Freedom from death, nonfatal MI, thrombosis, or any revascularization was 65%. Early experience indicates sirolimus-eluting stents for de novo saphenous vein graft lesions have a low (6%) rate of clinically driven target vessel revascularization. By 7-month follow-up, event-free survival is limited primarily by disease in nontarget vessels.
authors.affiliation: Division of Cardiovascular Diseases, Scripps Clinic, La Jolla, California, USA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Price
authors.forename: Neil
authors.initials: N
authors.lastname: Sawhney
authors.forename: John A
authors.initials: JA
authors.lastname: Kao
authors.forename: Antonio
authors.initials: A
authors.lastname: Madrid
authors.forename: Richard A
authors.initials: RA
authors.lastname: Schatz
authors.forename: Paul S
authors.initials: PS
authors.lastname: Teirstein
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000628:therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012501:Saphenous Vein; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus