Drug-eluting stents versus bare metal stents for narrowing in saphenous vein grafts.
Conflicting data exist regarding an advantage of drug-eluting stents (DES) over bare metal stents (BMS) in catheter-based treatment of saphenous vein graft (SVG) stenoses. This study was undertaken to compare the efficacy of these modalities in that lesion subset. The DES group consisted of 138 cases with 183 lesions (sirolimus-eluting stents, n = 117; paclitaxel-eluting stents, n = 66) and the BMS group consisted of 344 cases with 478 lesions that were followed to 1 year. We examined a composite end point that comprised death, Q-wave myocardial infarction, and target lesion revascularization. More BMS were deployed per patient (p <0.001) and the diameters of BMS deployed was significantly greater (p <0.001). Peak postprocedure values of creatine kinase-MB (p = 0.003) and troponin I (p = 0.05) were higher in BMS. At 1 year there was no significant superiority of DES over BMS with regard to hard end points (death and Q-wave myocardial infarction). In conclusion, this study indicates that both DES and BMS for SVG disease provide acceptably safe and efficacious results, but unlike the case in native coronary arteries, DES use does not reduce the frequency of the need for repeat revascularization.
Okabe
Teruo
T
Cardiovascular Research Institute, Washington Hospital Center, Washington, DC, USA.
Lindsay
Joseph
J
Buch
Ashesh N
AN
Steinberg
Daniel H
DH
Roy
Probal
P
Slottow
Tina L Pinto
TL
Smith
Kimberly
K
Torguson
Rebecca
R
Xue
Zhenyi
Z
Satler
Lowell F
LF
Kent
Kenneth M
KM
Pichard
Augusto D
AD
Weissman
Neil J
NJ
Waksman
Ron
R
D000368:Aged; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D020099:Coated Materials, Biocompatible; D017023:Coronary Angiography; D052279:Creatine Kinase, MB Form / Q000097:blood; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000601:surgery*; D006801:Humans; D008297:Male; D008670:Metals; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D012501:Saphenous Vein / Q000637:transplantation*; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
D020099:Coated Materials, Biocompatible; D008670:Metals; D052279:Creatine Kinase, MB Form