Paclitaxel-eluting stent long-term outcomes in percutaneous saphenous vein graft interventions (PELOPS) study.
This study examined the 1-year clinical and angiographic follow-up results of implantation of paclitaxel-eluting stents (PES) in aortocoronary saphenous vein graft (SVG) lesions. Sixty-eight consecutive patients with 90 nonoccluded SVG lesions were treated with PES (Taxus), size ranging from 2.25 to 4.5 mm. Angiographic follow-up was performed on 63 patients (93%) and 83 lesions (92%) at 12 months; major adverse cardiac event (MACE) was recorded in all patients at 1 year. The mean age of patients was 71+/-8 years with predominance of men (75%); the mean graft age was 13+/-4 years. Glycoprotein IIb/ IIIa inhibitors were given in 21 patients (31%); embolic protection devices were used in 54 lesions (60%). On average, patients received 1.4 stents per lesion with a stent size of 3.4+/-0.6 mm and a length of 35.8+/-27.0 mm. Angiographic follow-up revealed a late loss of 0.36+/-0.66 mm with an in-segment binary restenosis rate of 7%. The in-hospital MACE was 7%, which was solely contributed by 5 patients with postprocedure non-Q myocardial infarction; the 1-year MACE was 15%, accounted by 1 noncardiac death and 9 patients with target vessel revascularization. Peripheral vascular disease and the use of glycoprotein IIb/ IIIa inhibitors were the independent predictors of MACE at 1 year. In conclusion, implantation of PES to treat degenerative aortocoronary SVG lesions is safe and associated with low late loss, angiographic restenosis, and MACE at 1-year follow-up.
Jim
Man Hong
MH
Cardiac Medical Unit, Grantham Hospital, Hong Kong. jimmanh2002@yahoo.com
Ho
Hee Hwa
HH
Ko
Ryan Lap-yan
RL
Yiu
Kai Hang
KH
Siu
Chung Wah
CW
Lau
Chu Pak
CP
Chow
Wing Hing
WH
D000368:Aged; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D017239:Paclitaxel / Q000008:administration & dosage*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012501:Saphenous Vein / Q000637:transplantation*; D016896:Treatment Outcome; D050257:Tubulin Modulators / Q000008:administration & dosage*
D050257:Tubulin Modulators; D017239:Paclitaxel