Paclitaxel-eluting stents for chronically occluded saphenous vein grafts (EOS) study.
OBJECTIVE
The aim of this study was to report the feasibility, short- and medium-term results of percutaneous coronary intervention (PCI) on saphenous vein graft (SVG) chronic total occlusions (CTO) using paclitaxel-eluting stents (PES).


BACKGROUND
In postbypass patients, PCI on SVG CTO, rather than native vessel CTO, is another treatment option. However, the acute procedural and medium-term outcomes are unknown.


METHODS
Twenty-two consecutive, symptomatic postbypass patients underwent PCI on SVG CTO; angiographic success was seen in 16 patients (73%). The successful cases were evaluated at 1 year; restudy angiography was performed at 11 +/- 5 months in 15 patients (94%).


RESULTS
The patients had a mean age of 73 years with predominance of male (68%); the mean SVG age was 14 years. On average, patients received 3.4 PESs per lesion; the stent size was 3.5 +/- 0.4 mm with a total stent length of 98 +/- 34 mm. The use of embolic protection devices and glycoprotein IIb/ IIIa inhibitors was observed in 6 (38%) and 5 (31%) patients, respectively. The in-hospital major adverse cardiac event (MACE) was 13%, accountable by 2 patients with postprocedure myocardial infarction. At follow-up, 6 patients had angiographic restenosis (40%); there was 1 noncardiac death and 3 target vessel revascularizations. The 1-year MACE was 25%; the graft survival free of occlusion and revascularization was 56%.


CONCLUSIONS
PCI on SVG CTO is a feasible approach with a fairly high success and low in-hospital complication. However, it is associated with a relatively high angiographic restenosis and MACE at 1 year.
Jim
Man-Hong
MH
Cardiac Medical Unit, Grantham Hospital, Hong Kong, China.
Ho
Hee-Hwa
HH
Ko
Ryan Lap-Yan
RL
Siu
Chung-Wah
CW
Yiu
Kai-Hang
KH
Lau
Chu-Pak
CP
Chow
Wing-Hing
WH
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use; D002908:Chronic Disease; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D023903:Coronary Restenosis / Q000188:drug therapy* / Q000401:mortality / Q000517:prevention & control; D054855:Drug-Eluting Stents; D005240:Feasibility Studies; D005260:Female; D006083:Graft Occlusion, Vascular / Q000188:drug therapy* / Q000601:surgery / Q000628:therapy; D006723:Hong Kong; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D017239:Paclitaxel / Q000627:therapeutic use*; D012042:Registries; D012501:Saphenous Vein / Q000637:transplantation*; D013997:Time Factors; D016896:Treatment Outcome
D000972:Antineoplastic Agents, Phytogenic; D017239:Paclitaxel