Clinical follow-up of paclitaxel-eluting (TAXUS) stents for the treatment of saphenous vein graft disease.
BACKGROUND
Randomized trials in selected patient populations have demonstrated dramatic reductions in the incidence of in-stent restenosis (ISR) following implantation of paclitaxel-eluting (PE) coronary stents compared with bare metal stents in native coronary disease. The clinical outcome following implantation of PE stents for saphenous vein graft (SVG) stenosis is largely unknown.


OBJECTIVE
To assess the safety and efficacy of PE coronary stents for the treatment of SVG stenosis in an unselected population.


METHODS
All patients who received PE stents for the treatment of SVG disease from May 1, 2003, to May 1, 2005, were entered into a prospectively collected database. Fifty-five patients were identified with 69 lesions. In-hospital and late major adverse cardiac events (MACE) including death, myocardial infarction (MI), and target lesion revascularization (TLR) were recorded as well as the rate of target vessel revascularization (TVR).


RESULTS
Mean follow-up was 13 months with 54 of the 55 patients contacted. The number of stents implanted was 1.12 +/- 0.37 per lesion and 1.38 +/- 0.59 per patient. Clinically significant procedural MACE was 0%. The late MACE rate was 9% with a 2% clinically driven TLR, a 4% coronary artery bypass graft (CABG), and a 4% TVR rate. There were four deaths, two cardiac and two noncardiac.


CONCLUSIONS
PE stents appear safe and effective in the treatment of SVG disease at a mean follow-up time of 13 months. Randomized studies are needed to further delineate the optimal management of this high-risk group.
Department of Cardiology, St. Vincent's Hospital, Darlinghurst, NSW, Australia.
P E
PE
Ruchin
S C
SC
Faddy
D W M
DW
Muller
D W
DW
Baron
P R
PR
Roy
S H
SH
Wilson
D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D005260:Female; D006083:Graft Occlusion, Vascular / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D017239:Paclitaxel / Q000008:administration & dosage*; D011183:Postoperative Complications; D011446:Prospective Studies; D012501:Saphenous Vein / Q000637:transplantation*; D015607:Stents; D016019:Survival Analysis; D016896:Treatment Outcome
D017239:Paclitaxel