Long-term angiographic and clinical outcome after implantation of balloon-expandable stents in aortocoronary saphenous vein grafts

Am J Cardiol. 1994 Dec 15;74(12):1187-91. doi: 10.1016/0002-9149(94)90545-2.

Abstract

Balloon angioplasty of aortocoronary saphenous vein graft lesions is associated with high restenosis and clinical event rates. The goal of this multicenter study was to assess long-term angiographic and clinical outcome of patients electively treated with single Palmaz-Schatz stents in aortocoronary saphenous vein grafts. In 198 patients (209 lesions), elective placement of single Palmaz-Schatz stents was attempted. Angiography was performed at baseline, immediately after stent placement, and at 6-month follow-up. Stent placement was successful in 98.5% of patients. One patient (0.5%) had stent thrombosis. Restenosis occurred in 34% (45 of 133) of the restudied lesions. Restenosis was lower in de novo lesions than in restenotic lesions (22% vs 51%, p < 0.001). Ostial lesions had a higher restenosis rate than nonostial lesions (61% vs 28%, p = 0.003). Freedom from death, myocardial infarction, coronary artery bypass surgery, and repeat angioplasty was present in 70% of patients. Eighty-two percent of patients with de novo lesions remained event-free at 1 year, whereas only 55% of patients with prior angioplasty were event-free at 1 year (p < 0.001). The use of the Palmaz-Schatz stent for the treatment of focal, de novo, aortocoronary saphenous vein graft lesions is associated with a high procedural success rate, a low angiographic restenosis rate, and low clinical event rates, including the need for repeat revascularization. The results of this study need validation by a prospective randomized trial comparing stent implantation with angioplasty.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Angioplasty, Balloon, Coronary* / instrumentation
  • Coronary Artery Bypass*
  • Coronary Disease / surgery
  • Coronary Disease / therapy*
  • Disease-Free Survival
  • Female
  • Graft Occlusion, Vascular / therapy*
  • Humans
  • Male
  • Middle Aged
  • Recurrence
  • Saphenous Vein / transplantation
  • Stents* / adverse effects
  • Treatment Outcome