Efficacy of sirolimus-eluting stents as compared to paclitaxel-eluting stents for saphenous vein graft intervention.
BACKGROUND
Saphenous vein graft (SVG) intervention is associated with a significantly increased rate of periprocedural complications and late clinical and angiographic restenosis. In the contemporary drug-eluting stent (DES) era, the comparison of the efficacy of sirolimus-eluting stents (SES) with paclitaxel-eluting stents (PES) in SVG interventions is currently unknown. We conducted this retrospective analysis to investigate this issue.


RESULTS
Forty-seven patients with 50 SVG lesions who underwent standard percutaneous coronary intervention (PCI) with SES (SES group) were compared with 42 patients with 45 SVG lesions with PES (PES group). All patients received distal protection devices (DPDs) during the interventions. The in-hospital, 30-day, and 6-month clinical outcomes in both groups were compared. Baseline clinical and procedural characteristics were balanced between both groups except for the proximal and mid lesions. There were no deaths or Q-wave myocardial infarctions (MIs) during the index hospitalization. Non-Q-wave MI was similar between the two groups (SES vs PES, 4.3% vs 7.1%, P=0.55). At 30-day and 6-month follow-ups, all the clinical outcomes were similar between the two groups. There was no subacute thrombosis (SAT) or late thrombosis in either group. The event-free survival at 6 months was also similar between both groups (P=0.75).


CONCLUSIONS
The use of DES in patients undergoing SVG intervention with a DPD is clinically safe and feasible. As compared to SES, PES have the same efficacy and clinical outcomes in SVG interventions up to 6 months.
Chu
William W
WW
Division of Cardiology, Washington Hospital Center, Washington, DC 20010, USA.
Kuchulakanti
Pramod K
PK
Wang
Betty
B
Clavijo
Leonardo C
LC
Suddath
William O
WO
Pichard
Augusto D
AD
Satler
Lowell F
LF
Kent
Kenneth M
KM
Waksman
Ron
R
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D023903:Coronary Restenosis / Q000401:mortality; D018572:Disease-Free Survival; D004219:District of Columbia; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D009203:Myocardial Infarction / Q000401:mortality; D017239:Paclitaxel / Q000008:administration & dosage*; D011859:Radiography; D012501:Saphenous Vein / Q000637:transplantation*; D012720:Severity of Illness Index; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D017239:Paclitaxel; D020123:Sirolimus