title: Five-year follow-up of the plaque sealing with paclitaxel-eluting stents vs medical therapy for the treatment of intermediate nonobstructive saphenous vein graft lesions (VELETI) trial.
abstract: BACKGROUND
  Very few data exist on the long-term follow-up of patients with intermediate nonobstructive saphenous vein graft (SVG) lesions. The purpose of this study was to evaluate the 5-year clinical outcomes of the patients enrolled in the Moderate Vein Graft Lesion Stenting With the Taxus Stent and Intravascular Ultrasound (VELETI) and the factors associated with SVG disease progression and outcomes.
  
  
  METHODS
  Patients with ≥ 1 intermediate SVG lesion (30%-60% diameter stenosis) were randomized to either stenting the SVG lesion with a paclitaxel-eluting stent (PES group, n = 30) or to medical treatment alone (MT group, n = 27). All patients were followed yearly up to 5 years.
  
  
  RESULTS
  Major adverse cardiac events (MACEs) (cardiac death, myocardial infarction [MI], revascularization) related to the target SVG lesion tended to be lower in the PES group (17% vs 33%; P = 0.146) due to a lower lesion revascularization rate (13% vs 33%; P = 0.072), with no difference in cardiac death or MI between groups. MACEs related to the target SVG and global MACEs were similar between groups (P > 0.20 for both). A higher cholesterol level at baseline was the only independent predictive factor of MACEs related to the target SVG (P = 0.016).
  
  
  CONCLUSIONS
  Over a 5-year period, one third of intermediate lesions in old SVGs progressed, leading to a cardiac event. Stenting these lesions with PESs tended to improve clinical outcomes by reducing lesion progression but not SVG failure. Higher cholesterol levels were associated with SVG disease progression and clinical events. This pilot study provides the basis for a larger trial to determine the efficacy of intermediate SVG lesion plaque sealing.
authors.affiliation: Québec Heart and Lung Institute, Québec City, Québec, Canada. Electronic address: josep.rodes@criucpq.ulaval.ca.
authors.forename: Josep
authors.initials: J
authors.lastname: Rodés-Cabau
authors.affiliation: Québec Heart and Lung Institute, Québec City, Québec, Canada.
authors.forename: Olivier F
authors.initials: OF
authors.lastname: Bertrand
authors.affiliation: Québec Heart and Lung Institute, Québec City, Québec, Canada.
authors.forename: Eric
authors.initials: E
authors.lastname: Larose
authors.affiliation: Québec Heart and Lung Institute, Québec City, Québec, Canada.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Déry
authors.affiliation: Québec Heart and Lung Institute, Québec City, Québec, Canada.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Rinfret
authors.affiliation: Québec Heart and Lung Institute, Québec City, Québec, Canada.
authors.forename: Marina
authors.initials: M
authors.lastname: Urena
authors.affiliation: Québec Heart and Lung Institute, Québec City, Québec, Canada.
authors.forename: Miguel
authors.initials: M
authors.lastname: Jerez
authors.affiliation: Québec Heart and Lung Institute, Québec City, Québec, Canada.
authors.forename: Luis
authors.initials: L
authors.lastname: Nombela-Franco
authors.affiliation: Québec Heart and Lung Institute, Québec City, Québec, Canada.
authors.forename: Henrique B
authors.initials: HB
authors.lastname: Ribeiro
authors.affiliation: Québec Heart and Lung Institute, Québec City, Québec, Canada.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Allende
authors.affiliation: Québec Heart and Lung Institute, Québec City, Québec, Canada.
authors.forename: Guy
authors.initials: G
authors.lastname: Proulx
authors.affiliation: Québec Heart and Lung Institute, Québec City, Québec, Canada.
authors.forename: Can M
authors.initials: CM
authors.lastname: Nguyen
authors.affiliation: Québec Heart and Lung Institute, Québec City, Québec, Canada.
authors.forename: Jean-Rock
authors.initials: JR
authors.lastname: Boudreault
authors.affiliation: Québec Heart and Lung Institute, Québec City, Québec, Canada.
authors.forename: Jacques
authors.initials: J
authors.lastname: Rouleau
authors.affiliation: Québec Heart and Lung Institute, Québec City, Québec, Canada.
authors.forename: Louis
authors.initials: L
authors.lastname: Roy
authors.affiliation: Québec Heart and Lung Institute, Québec City, Québec, Canada.
authors.forename: Onil
authors.initials: O
authors.lastname: Gleeton
authors.affiliation: Québec Heart and Lung Institute, Québec City, Québec, Canada.
authors.forename: Gérald
authors.initials: G
authors.lastname: Barbeau
authors.affiliation: Québec Heart and Lung Institute, Québec City, Québec, Canada.
authors.forename: Bernard
authors.initials: B
authors.lastname: Noël
authors.affiliation: Québec Heart and Lung Institute, Québec City, Québec, Canada.
authors.forename: Mélanie
authors.initials: M
authors.lastname: Côté
authors.affiliation: Québec Heart and Lung Institute, Québec City, Québec, Canada.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Després
authors.affiliation: Québec Heart and Lung Institute, Québec City, Québec, Canada.
authors.forename: Gilles R
authors.initials: GR
authors.lastname: Dagenais
authors.affiliation: Québec Heart and Lung Institute, Québec City, Québec, Canada.
authors.forename: Robert
authors.initials: R
authors.lastname: DeLarochellière
mesh_terms: D000368:Aged; D000972:Antineoplastic Agents, Phytogenic / Q000494:pharmacology; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D017239:Paclitaxel / Q000494:pharmacology*; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging / Q000628:therapy*; D012501:Saphenous Vein / Q000637:transplantation; D015912:Thrombolytic Therapy / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D005343:Fibrinolytic Agents; D017239:Paclitaxel