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Drug-eluting stents vs. bare-metal stents in saphenous vein graft lesions

BACKGROUND: Although drug-eluting stents have markedly reduced restenosis and the need for repeat lesion revascularization in the vast majority of clinical and angiographic scenarios, the benefit of these devices for the treatment of saphenous-vein graft (SVG) lesions is yet to be defined. The aim of our study was to compare the rate of major adverse clinical events (MACE) between drug-eluting stents and bare-metal stents in SVG lesions in non-selected patients. METHODS: Patients treated in two tertiary hospitals between May 2006 and January 2009 were included. The primary objective was to compare the incidence of MACE between drug-eluting stents and bare-metal stents during hospitalization and in the long-term follow-up. RESULTS: Overall, 308 patients were consecutively enrolled and divided according to the type of stent deployed (209 with drug-eluting stents and 99 with bare-metal stents). Mean age was 68 years and SVG mean age was 10.9 years. In the in-hospital phase there was a trend towards higher MACE in the drug-eluting stents group (12% vs. 5.1%; P = 0.06). The incidence of MACE in up to 24 months was equivalent between groups (17.2% for the drug-eluting stents group vs. 18.2% for the bare-metal stents group; P = 0.87). Definite/probable stent thrombosis was similar in both groups (2.3% for the drug-eluting stents group vs. 2% for bare-metal stents group; P = 0.94). CONCLUSIONS: In this real world series of complex patients there was no long-term safety concerns related to the use of drug-eluting stents in the treatment of SVG lesions, with similar rates of cardiac death/myocardial infarction/stent thrombosis in both groups.

Stents; Drug-eluting stents; Saphenous vein


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