Beneficial 2-years results of drug-eluting stents in saphenous vein graft lesions

Abstract

There are limited data regarding clinical outcomes of drug-eluting stents (DES) in saphenous vein grafts (SVGs) compared to bare metal stents (BMS). Here we compared outcomes of DES in de novo SVG lesions versus BMS in contemporary percutaneous coronary intervention (PCI). We compared in-hospital, 6-month, 1-year and two years outcomes in 68 patients (72 grafts) who underwent PCI of SVG lesions using DES and a control BMS group composed of 43 patients (46 grafts) who underwent angioplasty in de novo SVG lesions. Major adverse cardiac events (MACE) included death, myocardial infarction (MI), target lesion revascularisation (TLR), and target vessel revascularisation (TVR). The rates of TLR and TVR at the 1-year evaluation were lower in the DES group than the BMS group (TLR per patient, 7.4% vs. 21%, P=0.04; TVR per patient, 10.3% vs. 23.3%, P=0.1). MACE-free survival was 88.2% in the DES group and 69.8% in the BMS group (P=0.02). At two years clinical follow-up: death 2.9% vs. 4.7% (P=0.6); MI: 8.8% vs. 7% (P=0.6). The rates of TLR and TVR were significantly lower in the DES group compared to the BMS group (TLR per patient, 14.7% vs. 32.6%, P=0.03; TVR per patient, 10.3% vs. 27.9%, P=0.02). The rate of MACE-free survival was 79.4% in the DES group and 58.1% in the BMS group (P=0.02). Between one to two years after PCI, no cases of angiographic stent thrombosis were recorded in either group. DES implantation in SVG lesions was safe and had favourable outcomes after two years without excess cardiac mortality.