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Clinical outcomes after sirolimus‐eluting stent implantation for de novo saphenous vein graft lesions
Author(s) -
Price Matthew J.,
Sawhney Neil,
Kao John A.,
Madrid Antonio,
Schatz Richard A.,
Teirstein Paul S.
Publication year - 2005
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.20369
Subject(s) - medicine , myocardial infarction , restenosis , sirolimus , stent , surgery , cardiology , revascularization , coronary artery disease , thrombosis , clinical endpoint , randomized controlled trial
The purpose of this study was to evaluate the clinical outcome of patients undergoing sirolimus‐eluting stent implantation for de novo lesions within saphenous vein grafts (SVGs). Although the incidence of restenosis following sirolimus‐eluting stenting (SES) of native coronary arteries is low, the efficacy of SES to treat de novo lesions within SVGs has not been well studied. A total of 35 patients underwent SES implantation of 39 lesions during 36 procedures. All patients had a minimum follow‐up of 6 months following the index procedure. The mean bypass graft age was 10.1 ± 6.5 years (range, 0–23 years). In‐hospital major adverse cardiac events [death, myocardial infarction, thrombosis, or target vessel revascularization (TVR)] occurred in four patients (11%). Clinical follow‐up was obtained in 100% of patients (mean follow‐up, 7.5 ± 2.2 months). There was one cardiac death, presumed due to stent thrombosis. TVR occurred in only two patients (6%). Myocardial infarction (MI) occurred in four patients (11%), all attributable to a nontarget vessel. The combined endpoint of death, MI, or TVR occurred in seven patients (20%). Freedom from death, nonfatal MI, thrombosis, or any revascularization was 65%. Early experience indicates sirolimus‐eluting stents for de novo saphenous vein graft lesions have a low (6%) rate of clinically driven target vessel revascularization. By 7‐month follow‐up, event‐free survival is limited primarily by disease in nontarget vessels. © 2005 Wiley‐Liss, Inc.