Late Lumen Loss of Drug Eluting Stents versus Bare Mental Stents for Saphenous Vein Graft Intervention
摘要
BACKGROUND: Drug eluting stents (DESs) has been applied in treatment of saphenous vein grafts, but few reports are present. OBJECTIVE: To retrospectively compare the late loss and major adverse cardiac events (MACE) between DES and bare mental stents (BMS) in patients with diseased saphenous vein grafts. DESIGN, TIME AND SETTING: The experiment, a grouping control study and follow-up observation, was performed from January 2002 to February 2007 in Beijing Luhe Hospital and Beijing Anzhen Hospital. PARTICIPANTS: Ninety-seven consecutive patients with saphenous vein graft lesions were treated with DESs (DES group, n=50) or BMSs (BMS group, n=47). METHODS: All patients underwent percutaneous coronary implantation and received clinical follow-ups immediately. They were scheduled to undergo 12-month coronary angiography. MAIN OUTCOME MEASURES: The cardiac events including death, myocardial infarction, target lesion and/or target vessel revascularization. Late lumen loss was recorded and compared between the two groups. RESULTS: There were no significant differences on the gender, age, history of bridge vessels and complication between the two groups (P＞0.05). A total of 97 patients with 118 lesions localized in 105 diseased saphenous vein grafts were included: 50 patients received 71 DESs for 59 lesions, whereas 47 patients received 62 BMSs for 59 lesions. Procedural success was achieved in 94.0% of patients in the DES group and 93.6% in BMS group (P=0.43). At 12 months, the cumulative incidence of MACE was significantly lower in DES group than in BMS group (12.0% vs. 29.8%, P=0.03). Angiographic follow-up was available for 54 patients, 26 patients in DES group and 28 in BMS group. Late lumen loss was significantly reduced in DES group [(0.32±0.65) mm vs. (0.79±1.23) mm, P=0.0l]. The DES group had a significantly lower incidence of target lesion revascularization compared with BMS group (6.0% vs. 19.1%, P=0.05). By Cox regression analysis, independent predictors fo