Abstract

AimsTo describe the safety and performance of STENTYS self-expandable bare metal stents (BMS) versus paclitaxel-eluting stents (PES) in saphenous vein grafts (SVGs).Methods and ResultsA randomised controlled trial was performed in four hospitals in three European countries between December 2011 and December 2013. Patients with de novo lesions (>50% stenosis) in an SVG with a diameter between 2.5–6 mm were included. Primary endpoint was late lumen loss at 6 months. Secondary endpoints included procedural success and the occurrence of major adverse cardiac events (MACE) at 12 months. A total of 57 patients were randomised to STENTYS self-apposing BMS (n = 27) or PES (n = 30). Procedural success was obtained in 89.5%. No significant differences in late lumen loss were found between BMS and PES at 6 months (0.53 mm vs 0.47; p = 0.86). MACE rates at 12 months were comparable in both groups (BMS 22.2% vs. PES 26.7%; p = 0.70).ConclusionsTreatment of SVGs with STENTYS self-expandable stents is safe and effective. No significant differences were found in late lumen loss and MACE between BMS and PES.

Highlights

  • Saphenous vein grafts (SVGs) can occlude over time because of thrombosis, intimal hyperplasia and atherosclerosis

  • Occlusions of saphenous vein grafts (SVGs) are reported in 10–15% of patients within 1 year after coronary artery bypass grafting (CABG)

  • SVGs were treated with balloon angioplasty alone

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Summary

Introduction

Saphenous vein grafts (SVGs) can occlude over time because of thrombosis, intimal hyperplasia and atherosclerosis. Occlusions of SVGs are reported in 10–15% of patients within 1 year after coronary artery bypass grafting (CABG). 10% of the patients being treated in a high-volume catheterisation lab are patients who need treatment of their occluded SVGs [2]. These patients can encounter complications such as embolisation, peri-procedural myocardial infarction (MI), increased incidence of restenosis, repeat percutaneous coronary intervention (PCI) and a faster progression of moderate ‘non-significant’ lesions, treated during the first intervention [3, 4]. SVGs were treated with balloon angioplasty alone. The SAVED trial showed beneficial procedural results and a decrease in major adverse cardiac events (MACE) with the use of bare metal stents (BMS) compared with balloon angioplasty [5]

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