VA North Texas Healthcare System and University of Texas Southwestern Medical Center, Dallas, TX, USA.
EuroIntervention. 2010 Jan;5(6):722-30. doi: 10.4244/eijv5i6a119.
A systematic review of the outcomes after drug-eluting stents (DES) implantation in saphenous vein grafts (SVGs) was performed.
The majority of the 33 published studies were retrospective with only two prospective randomised trials. Late loss and binary restenosis was reduced compared to bare metal stents (BMS) in all seven studies with angiographic follow-up. With the exception of one study there was no difference in mortality, myocardial infarction, or stent thrombosis between BMS and DES. The need for repeat target vessel or lesion revascularisation was lower in the DES arm in approximately half the published studies and similar in the remaining studies.
Until data from large, prospective, randomised-controlled studies become available, DES implantation in SVGs appears to be safe and, although not yet definitively proven, likely to reduce angiographic restenosis and the need for repeat target lesion revascularisation.
对药物洗脱支架(DES)在静脉桥(SVG)中的应用效果进行了系统评价。
33 篇已发表的研究中,大多数为回顾性研究,仅有两项前瞻性随机试验。在所有七项具有血管造影随访的研究中,与金属裸支架(BMS)相比,晚期丢失和二元再狭窄均减少。除了一项研究外,BMS 和 DES 在死亡率、心肌梗死或支架血栓形成方面没有差异。在大约一半的已发表研究中,DES 组的再次靶血管或病变血运重建的需求较低,而在其余研究中则相似。
在大型前瞻性随机对照研究数据公布之前,DES 在 SVG 中的应用似乎是安全的,尽管尚未得到明确证实,但可能会降低血管造影再狭窄和再次靶病变血运重建的需求。