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Membrane‐covered stents: A new treatment strategy for saphenous vein graft lesions
Author(s) -
Baldus Stephan,
Köster Ralf,
Reimers Jacobus,
Kähler Jan,
Meinertz Thomas,
Hamm Christian W.
Publication year - 2001
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.1119
Subject(s) - medicine , restenosis , stent , lesion , angioplasty , surgery , circumflex , revascularization , artery , target lesion , vein , covered stent , saphenous vein graft , radiology , cardiology , myocardial infarction , percutaneous coronary intervention
The restenosis rate after stenting of lesions in aortocoronary venous bypass grafts still has to be considered unsatisfactorily high. We investigated a new stent design characterized by an expandable polytetrafluorethylene (PTFE) membrane in between two layers of struts. Five consecutive male patients (age 70 ± 6 years) were followed prospectively who presented with at least two de novo lesions in different grafts 13 ± 3 years after bypass surgery. A total of 11 lesions were treated located in grafts anastomosed to the circumflex ( n = 3), to the LAD ( n = 7), and to the right coronary artery ( n = 1). Within the same procedure, every patient received membrane‐covered stents ( n = 6) and conventional stents ( n = 5) in either of their lesions. All patients underwent successful interventions. The minimal luminal diameter increased from 1.0 ± 0.5 to 2.9 ± 0.6 mm in lesions treated by the membrane‐covered stents and from 0.8 ± 0.4 to 2.4 ± 0.7 mm in the lesions treated by conventional stents. During follow‐up, four out of five patients required angioplasty for in‐stent restenosis of lesions covered by a conventional stent, whereas no patient underwent revascularization for a lesion treated by a membrane‐covered device. The mean minimal luminal diameter of lesions covered by a conventional stent decreased by 42% to 1.4 ± 0.6 mm; the mean minimal luminal diameter of the lesions treated by a stent graft declined by 9% to 2.8 ± 0.6 mm ( P < 0.05). This series of intraindividual comparisons suggests that membrane‐covered stents may have the power to reduce in‐stent restenosis in obstructed aortocoronary venous bypass grafts. Cathet Cardiovasc Intervent 2001;53:1–4. © 2001 Wiley‐Liss, Inc.