1996-07-01
Long-term clinical outcome after stent implantation in saphenous vein grafts
Publication
Publication
Journal of the American College of Cardiology , Volume 28 - Issue 1 p. 89- 96
Objectives. We sought to determine the role of stent implantation in vein grafts by evaluating the long-term clinical outcome and estimated event-free survival at 5 years in 62 patients and by comparing our data with those of other treatment modalities previously reported. Background. Patients with recurrent angina after coronary artery bypass graft surgery pose a problem. Stent implantation has been advocated in an effort to avoid repeat operation and to address the limitations of balloon angioplasty. Methods. Patients undergoing stenting of a vein graft were entered into a dedicated data base. They were screened for death, infarction, bypass surgery and repeat angioplasty. Procedure-related events were included in the follow-up analysis. Survival and event-free survival curves were constructed by the Kaplan-Meier method. Results. A total of 93 stents (84 Wallstent and 9 Palmaz-Schatz) were implanted in 62 patients. During the in- hospital period, seven patients (11%) sustained a major cardiac event: two deaths (3%), two myocardial infarctions (3%) and three urgent bypass surgeries (5%). The clinical success rate, therefore, was 89%. During the follow-up period (median 2.5 years, range 0 to 5.9), another five patients (8%) died, 14 (23%) sustained a myocardial infarction, 12 (20%) underwent bypass surgery, and 14 (23%) underwent angioplasty. The estimated 5-year survival and event-free survival rates (free from infarction, repeat surgery and repeat angioplasty) were (mean ± SD) 83 ± 5% (95% confidence interval [CI] 73% to 93%) and 30 ± 7% (95% CI 16% to 44%), respectively. Conclusions. The in-hospital outcome of patients who underwent stent implantation in a vein graft is acceptable, but the long-term clinical outcome is poor. It is unlikely that mechanical intervention alone will provide a satisfactory or definite answer for the patient with graft sclerosis over the long term.
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| doi.org/10.1016/0735-1097(96)00104-0, hdl.handle.net/1765/57765 | |
| Journal of the American College of Cardiology | |
| Organisation | Department of Cardiology |
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de Jaegere, P., van Domburg, R., de Feyter, P., Ruygrok, P., van der Giessen, W., van den Brand, M., & Serruys, P. (1996). Long-term clinical outcome after stent implantation in saphenous vein grafts. Journal of the American College of Cardiology, 28(1), 89–96. doi:10.1016/0735-1097(96)00104-0 |
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