Late lumen loss of drug eluting stents versus bare mental stents for saphenous vein graft intervention

Jincheng GUO; Min XU; Guozhong WANG; Changsheng MA

ABSTRACT

BACKGROUND:

Drug eluting stents(DESs)has been applied in treatment of saphenous vein grafts,but few reports are present.

OBJECTIVE:

To retrospectively compare the late loss and major adverse cardiac events(MACE)between DES and bare mental stents(BMS)in patients with diseased saphenous vein grafts.DESIGN,TIME AND

SETTING:

The experiment,a grouping control study and follow-up observation,was performed from January 2002 to February 2007 in Beijing Luhe Hospitat and Beijing Anzhen Hospital.

PARTICIPANTS:

Ninety-seven consecutive patients with saphenous vein graft lesions were treated with DESs (DESgroup.n=50)or BMSs(BMS group,n=47).

METHODS:

All patients underwent percutaneous coronary implantation and received clinical follow-ups immediately.They were scheduled to undergo 12-month coronary angiography.MAIN OUTCOME

MEASURES:

The cardiac events including death,myocardial infarction,target lesion and/or target vessel revascularization.Late lumen loss was recorded and compared between the two groups.

RESULTS:

There were no significant differences on the gender,age,history of bridge vessels and complication between the two groups(P>0.05).A total of 97 patients with 118 lesions localized in 105 diseased saphenous vein grafts were included50 patients received 71 DESs for 59 lesions,whereas 47 patients received 62 BMSs for 59 lesions.Procedural success was achieved in 94.0%of patients in the DES group and 93.6%in BMS group(P=0.43).At 12 months,the cumulative incidence of MACE was significantly lower in DES group than in BMS group(1 2.0%vs.29.8%.P=0.03).Angiographic follow-up was available for 54 patients,26 patients in DES group and 28 in BMS group.Late lumen loss was significantly reduced in DES group[(0.32±0.65)mm vs.(0.79±1.23)mm,P=0.01].The DES group had a significantly lower incidence of target lesion revascularization compared with BMS group(6.0%vs.19.1%.P=0.05).By Cox regression analysis,independent predictors for MACE at 12-month follow-ups were diabetes (OR2.37;CI0.95 to 5.88;P=0.064),BMS(OR2.86;CI0.98 to 8.34;P=0.05),and stent per lesion(OR2.92;CI1.25 to 6.82;P=0.01).

CONCLUSION:

DES is superior to BMS in diseased saphenous vein grafts,and it can significantly reduce late lumen loss and MACE.