title: Prevalence and outcomes of intermediate saphenous vein graft lesions: findings from the stenting of saphenous vein grafts randomized-controlled trial.
abstract: BACKGROUND
  We sought to examine the prevalence and progression rate of intermediate saphenous vein graft (SVG) lesions in the Stenting Of Saphenous vein grafts (SOS) trial.
  
  
  METHODS
  The baseline and follow-up angiograms of 80 patients participating in the SOS trial were analyzed to determine the prevalence of intermediate (30-60% angiographic diameter stenosis) SVG lesions and their progression rate.
  
  
  RESULTS
  At least one intermediate SVG lesion was present in 31 of 143 (22%) SVGs in 27 of 80 (34%) patients. Most intermediate lesions were present in the SOS stented SVGs (20 grafts in 19 patients). During a median follow-up of 35 months, angiographic follow-up was available for 28 grafts in 25 patients. Progression (defined as percent diameter stenosis ≥ 70% but <100% at follow-up angiography) was seen in 11 of 28 SVGs (39%) in 11 of 25 patients (44%). Progression rate at 12, 24 and 36 months was 28% and 47% and 84%, respectively. Seven of 11 patients (64%) with intermediate SVG lesion progression presented with an acute coronary syndrome and 8 (73%) underwent PCI. Four of the 28 grafts with intermediate lesions at baseline were 100% occluded at follow-up; all of those SVGs had received a stent in another location in the SVG as part of the SOS trial.
  
  
  CONCLUSIONS
  Intermediate SVG lesions are common in patients undergoing SVG stenting, have high rates of progression and frequently present with an acute coronary syndrome. Further study of pharmacologic and mechanical treatments to prevent progression of these lesions is needed.
authors.affiliation: Veteran Affairs North Texas Healthcare System, Dallas, TX, USA; University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Abdul-Rahman R
authors.initials: AR
authors.lastname: Abdel-Karim
authors.forename: Monica
authors.initials: M
authors.lastname: Da Silva
authors.forename: Christopher
authors.initials: C
authors.lastname: Lichtenwalter
authors.forename: James A
authors.initials: JA
authors.lastname: de Lemos
authors.forename: Owen
authors.initials: O
authors.lastname: Obel
authors.forename: Tayo
authors.initials: T
authors.lastname: Addo
authors.forename: Michele
authors.initials: M
authors.lastname: Roesle
authors.forename: Donald
authors.initials: D
authors.lastname: Haagen
authors.forename: Bavana V
authors.initials: BV
authors.lastname: Rangan
authors.forename: Lorenza
authors.initials: L
authors.lastname: Makke
authors.forename: Omar M
authors.initials: OM
authors.lastname: Jeroudi
authors.forename: Deepa
authors.initials: D
authors.lastname: Raghunathan
authors.forename: Bilal
authors.initials: B
authors.lastname: Saeed
authors.forename: Joseph K
authors.initials: JK
authors.lastname: Bissett
authors.forename: Rajesh
authors.initials: R
authors.lastname: Sachdeva
authors.forename: Vassilios V
authors.initials: VV
authors.lastname: Voudris
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Karyofillis
authors.forename: Biswajit
authors.initials: B
authors.lastname: Kar
authors.forename: James
authors.initials: J
authors.lastname: Rossen
authors.forename: Panayotis
authors.initials: P
authors.lastname: Fasseas
authors.forename: Peter
authors.initials: P
authors.lastname: Berger
authors.forename: Subhash
authors.initials: S
authors.lastname: Banerjee
authors.forename: Emmanouil S
authors.initials: ES
authors.lastname: Brilakis
mesh_terms: D054058:Acute Coronary Syndrome / Q000453:epidemiology*; D000368:Aged; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D012501:Saphenous Vein / Q000637:transplantation*; D015607:Stents
keywords: CABG; Coronary Artery Bypass Graft; HDL; High Density Lipoprotein; LDL; Low Density Lipoprotein; PCI; Percutaneous Coronary Intervention; Percutaneous Coronary Interventions; SOS; SVG; Saphenous Vein Graft; Saphenous vein grafts; Stenting Of Saphenous vein grafts trial; Stents