INTRODUCTION AND OBJECTIVES: Drug-eluting stents (DES) reduce the restenosis rate in native vessels. However, results in saphenous vein grafts (SVG) are less clear. The aim of this study was to compare DES and bare metal stents (BMS) in de novo stenosis in SVG. METHODS: The study included all percutaneous interventions involving a DES in SVG carried out at five centers up until July 2007. Findings were compared with those in a historical cohort that used conventional stents at two centers. The study analyzed in-hospital and long-term outcomes and predictors of survival and revascularization. RESULTS: The study included 107 stenoses treated with DESs in 98 patients and 130 stenoses treated with BMS in 113 patients. The DES group was older at baseline and had thrombus less often. There were also procedural differences: in the DES group, stents were longer, direct stenting was used less, and the stent diameter was smaller. The proportion of patients who experienced cardiac death by 12, 24 and 30 months was 95%+/-2%, 91%+/-3% and 89%+/-3%, respectively, in the DES group and 95%+/-2%, 90%+/-3% and 87%+/-3% in the BMS group (P=.66). The proportion without target vessel revascularization at 12, 24 and 30 months was 90%+/-3%, 86%+/-4% and 83%+/-4%, respectively, in the DES group and 94%+/-2%, 87%+/-3% and 87%+/-3% in the BMS group (P=.49). The only predictor of cardiac death was the ejection fraction. There was no predictor of revascularization. CONCLUSIONS: In our series, using DESs in SVGs was not associated with a reduction in mortality or target vessel revascularization. The only predictor of cardiac death was the ejection fraction. There was no predictor of revascularization.
INTRODUCTION AND OBJECTIVES: Drug-eluting stents (DES) reduce the restenosis rate in native vessels. However, results in saphenous vein grafts (SVG) are less clear. The aim of this study was to compare DES and bare metal stents (BMS) in de novo stenosis in SVG. METHODS: The study included all percutaneous interventions involving a DES in SVG carried out at five centers up until July 2007. Findings were compared with those in a historical cohort that used conventional stents at two centers. The study analyzed in-hospital and long-term outcomes and predictors of survival and revascularization. RESULTS: The study included 107 stenoses treated with DESs in 98 patients and 130 stenoses treated with BMS in 113 patients. The DES group was older at baseline and had thrombus less often. There were also procedural differences: in the DES group, stents were longer, direct stenting was used less, and the stent diameter was smaller. The proportion of patients who experienced cardiac death by 12, 24 and 30 months was 95%+/-2%, 91%+/-3% and 89%+/-3%, respectively, in the DES group and 95%+/-2%, 90%+/-3% and 87%+/-3% in the BMS group (P=.66). The proportion without target vessel revascularization at 12, 24 and 30 months was 90%+/-3%, 86%+/-4% and 83%+/-4%, respectively, in the DES group and 94%+/-2%, 87%+/-3% and 87%+/-3% in the BMS group (P=.49). The only predictor of cardiac death was the ejection fraction. There was no predictor of revascularization. CONCLUSIONS: In our series, using DESs in SVGs was not associated with a reduction in mortality or target vessel revascularization. The only predictor of cardiac death was the ejection fraction. There was no predictor of revascularization.
Authors: Pascal Meier; Emmanouil S Brilakis; Roberto Corti; Guido Knapp; Mehdi H Shishehbor; Hitinder S Gurm Journal: PLoS One Date: 2010-06-10 Impact factor: 3.240