Implantation of paclitaxel-eluting stents in saphenous vein grafts: clinical and angiographic follow-up results from a multicentre study. Issue 3 (29th August 2006)

• Record Type: Journal Article
• Authors: Hoffmann, Rainer; Pohl, Tilmann; Köster, Ralf; Blindt, Ruediger; Boeckstegers, Peter; Heitzer, Thomas
• Is Part Of: Heart. Volume 93:Issue 3(2007)
• Page Start: 331
• Page End: 334
• Publication Date: 2006-08-29
• Subjects: ASPECT, Asian Paclitaxel-Eluting Stent Clinical Trial -- BMS, bare metal stent -- ELUTES, European evaLUation of pacliTaxel-eluting stent -- MACE, major adverse cardiac events -- MLD, minimal lumen diameter -- PES, paclitaxel-eluting stent -- SVG, saphenous vein graft -- TIMI, thrombolysis in myocardial infarction -- TLR, target lesion revascularisation; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/hrt.2006.094722
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Objective: To define the clinical and angiographic follow-up results after implantation of paclitaxel-eluting stents (PESs) in stenotic saphenous vein grafts (SVGs). Design: Prospective multicentre study. Comparison with a control group. Methods: 60 consecutive patients with 65 lesions located in 65 SVGs (mean (SD) age of vein grafts 11.3 (5.7) years) treated with PES (V-Flex Plus, 2.7 μg/mm 2 paclitaxel, Cook) and 60 patients with 60 SVG lesions treated with bare metal stent (BMS) were included. Lesions had to be <20 mm in length and in grafts of 2.75–3.5 mm diameter. The 6 month angiographic follow-up was obtained on 51 lesions (79%) of the PES group and on 51 lesions (85%) of the BMS group. Results: Baseline clinical and angiographic characteristics were comparable between both groups. At angiographic follow-up, three vein grafts in the PES group and five vein grafts in the BMS group were occluded. In-stent late lumen loss was lower in PES than in BMS (0.61 (0.81) vs 1.06 (0.72) mm, respectively; p = 0.021). In-stent binary restenosis rates were 12% vs 33%, respectively, (p = 0.012). Linear regression analysis showed BMS to be the only factor with an effect on late lumen loss (p = 0.011). Target-vessel failure rates were 18% in the PES group and 41% in the BMS group (p = 0.019), whereas major adverse cardiac event (MACE) rates at 180 days were 15% and 37%, respectively (p = 0.014). Conclusions: Implantation of non-polymer-based PES in SVG lesions is associated with a lower late lumen loss and restenosis rate than those of BMS. There remains a substantial target-vessel failure rate and MACE rate even at 6 months owing to graft occlusion or new lesions in the graft.