Assali Abid, Raz Yael, Vaknin-Assa Hana, Ben-Dor Itsik, Brosh David, Teplitsky Igal, Fuchs Shmuel, Kornowski Ran
Cardiac Catheterisation Laboratories, Department of Cardiology, Rabin Medical Center, Petach Tikva, Israel.
EuroIntervention. 2008 May;4(1):108-14. doi: 10.4244/eijv4i1a18.
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.
与裸金属支架（BMS）相比，关于药物洗脱支架（DES）在大隐静脉移植血管（SVG）中的临床结果的数据有限。在此，我们比较了在当代经皮冠状动脉介入治疗（PCI）中，DES用于初发SVG病变与BMS的结果。
我们比较了68例（72条移植血管）接受SVG病变PCI的患者的住院、6个月、1年和2年的结果，以及一个由43例（46条移植血管）在初发SVG病变中接受血管成形术的患者组成的对照BMS组。主要不良心脏事件（MACE）包括死亡、心肌梗死（MI）、靶病变血运重建（TLR）和靶血管血运重建（TVR）。DES组在1年评估时的TLR和TVR发生率低于BMS组（每位患者的TLR，7.4%对21%，P = 0.04；每位患者的TVR，10.3%对23.3%，P = 0.1）。DES组无MACE生存率为88.2%，BMS组为69.8%（P = 0.02）。在2年临床随访时：死亡2.9%对4.7%（P = 0.6）；MI：8.8%对7%（P = 0.6）。DES组的TLR和TVR发生率显著低于BMS组（每位患者的TLR，14.7%对32.6%，P = 0.03；每位患者的TVR，10.3%对27.9%，P = 0.02）。DES组无MACE生存率为79.4%，BMS组为58.1%（P = 0.02）。在PCI后1至2年期间，两组均未记录到血管造影支架血栓形成病例。
在SVG病变中植入DES是安全的，且2年后有良好的结果，无额外的心脏死亡率。
