Patients with in-stent restenosis have an increased risk of mid-term venous graft failure.
BACKGROUND
This study was designed to evaluate if patients in whom in-stent restenosis developed had an higher risk of early venous graft failure compared with normal patients.


METHODS
The study cohort comprised 120 patients (60 with previous in-stent restenosis and 60 controls) who received a total of 165 complementary venous grafts on the circumflex or right coronary artery system (84 in the restenosis group and 81 in the control group). All patients were prospectively followed-up and underwent reangiography at 5-years follow-up.


RESULTS
In the restenosis group, 28 venous grafts (33.%) were perfectly patent, 10 showed major irregularities, and 46 were occluded. In the control patients, 50 grafts (61.7%) were perfectly patent (p < 0.001 compared with the restenosis series), 12 showed major irregularities (p = .74), and 19 were occluded (p < 0.0001). In contrast, the 5-year outcome of internal thoracic artery grafts was not affected by history of in-stent restenosis.


CONCLUSIONS
Patients who developed in-stent restenosis have an higher risk of early venous graft failure compared with the control patients. Arterial grafts should probably be preferred in these patients.
Gaudino
Mario
M
Department of Cardiac Surgery, Catholic University, Rome, Italy. mgaudino@tiscali.it
Luciani
Nicola
N
Glieca
Franco
F
Cellini
Carlo
C
Pragliola
Claudio
C
Trani
Carlo
C
Burzotta
Francesco
F
Schiavoni
Giovanni
G
Anselmi
Amedeo
A
Possati
Gianfederico
G
D000368:Aged; D015331:Cohort Studies; D015897:Comorbidity; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods / Q000706:statistics & numerical data*; D003324:Coronary Artery Disease / Q000503:physiopathology / Q000601:surgery; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D048909:Diabetes Complications / Q000503:physiopathology / Q000601:surgery; D017558:Elective Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000453:epidemiology*; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009928:Organ Specificity; D011446:Prospective Studies; D012306:Risk; D012501:Saphenous Vein / Q000473:pathology / Q000637:transplantation; D015607:Stents