Percutaneous Coronary Intervention with Newer Generation Stents

Abstract

Luminal narrowing of saphenous vein grafts (SVG) after coronary artery bypass grafting is common and often requires percutaneous coronary intervention (PCI). The introduction of first-generation drug-eluting stents (DES) has dramatically reduced restenosis and the need for subsequent repeat revascularization after native vessel PCI compared with bare-metal stents (BMS). It has also been shown that the use of DES in SVG intervention is safe and effective. Therefore, DES are generally preferred over BMS in SVG PCI. Recently, the adoption of newer-generation DES and their unrestricted use in native coronary artery PCI has demonstrated that these devices are not only more effective but also safer than first-generation DES. However, it is unknown whether the superiority of newer-generation DES over first-generation DES shown in native coronary artery lesions is extended to SVG lesions. Moreover, there are limited data to support the choice of the type of DES to be used for SVG lesions. This chapter reviews the results reported so far on the newer-generation DES in SVG PCI.