TY - JOUR
T1 - Prevalence and outcomes of intermediate saphenous vein graft lesions
T2 - Findings from the stenting of saphenous vein grafts randomized-controlled trial
AU - Abdel-Karim, Abdul Rahman R
AU - Da Silva, Monica
AU - Lichtenwalter, Christopher
AU - de Lemos, James A
AU - Obel, Owen
AU - Addo, Tayo A
AU - Roesle, Michele
AU - Haagen, Donald
AU - Rangan, Bavana Venkata
AU - Makke, Lorenza
AU - Jeroudi, Omar M.
AU - Raghunathan, Deepa
AU - Saeed, Bilal
AU - Bissett, Joseph K.
AU - Sachdeva, Rajesh
AU - Voudris, Vassilios V.
AU - Karyofillis, Panagiotis
AU - Kar, Biswajit
AU - Rossen, James
AU - Fasseas, Panayotis
AU - Berger, Peter
AU - Banerjee, Subhash
AU - Brilakis, Emmanouil S
N1 - Funding Information:
Dr. Banerjee has served on the Speakers’ Bureau for St. Jude Medical Center, Medtronic Corp., and Johnson & Johnson and has received a research grant from Boston Scientific.
PY - 2013/10/3
Y1 - 2013/10/3
N2 - Background We sought to examine the prevalence and progression rate of intermediate saphenous vein graft (SVG) lesions in the Stenting Of Saphenous vein grafts (SOS) trial. Methods The baseline and follow-up angiograms of 80 patients participating in the SOS trial were analyzed to determine the prevalence of intermediate (30-60% angiographic diameter stenosis) SVG lesions and their progression rate. Results At least one intermediate SVG lesion was present in 31 of 143 (22%) SVGs in 27 of 80 (34%) patients. Most intermediate lesions were present in the SOS stented SVGs (20 grafts in 19 patients). During a median follow-up of 35 months, angiographic follow-up was available for 28 grafts in 25 patients. Progression (defined as percent diameter stenosis ≥ 70% but < 100% at follow-up angiography) was seen in 11 of 28 SVGs (39%) in 11 of 25 patients (44%). Progression rate at 12, 24 and 36 months was 28% and 47% and 84%, respectively. Seven of 11 patients (64%) with intermediate SVG lesion progression presented with an acute coronary syndrome and 8 (73%) underwent PCI. Four of the 28 grafts with intermediate lesions at baseline were 100% occluded at follow-up; all of those SVGs had received a stent in another location in the SVG as part of the SOS trial. Conclusions Intermediate SVG lesions are common in patients undergoing SVG stenting, have high rates of progression and frequently present with an acute coronary syndrome. Further study of pharmacologic and mechanical treatments to prevent progression of these lesions is needed.
AB - Background We sought to examine the prevalence and progression rate of intermediate saphenous vein graft (SVG) lesions in the Stenting Of Saphenous vein grafts (SOS) trial. Methods The baseline and follow-up angiograms of 80 patients participating in the SOS trial were analyzed to determine the prevalence of intermediate (30-60% angiographic diameter stenosis) SVG lesions and their progression rate. Results At least one intermediate SVG lesion was present in 31 of 143 (22%) SVGs in 27 of 80 (34%) patients. Most intermediate lesions were present in the SOS stented SVGs (20 grafts in 19 patients). During a median follow-up of 35 months, angiographic follow-up was available for 28 grafts in 25 patients. Progression (defined as percent diameter stenosis ≥ 70% but < 100% at follow-up angiography) was seen in 11 of 28 SVGs (39%) in 11 of 25 patients (44%). Progression rate at 12, 24 and 36 months was 28% and 47% and 84%, respectively. Seven of 11 patients (64%) with intermediate SVG lesion progression presented with an acute coronary syndrome and 8 (73%) underwent PCI. Four of the 28 grafts with intermediate lesions at baseline were 100% occluded at follow-up; all of those SVGs had received a stent in another location in the SVG as part of the SOS trial. Conclusions Intermediate SVG lesions are common in patients undergoing SVG stenting, have high rates of progression and frequently present with an acute coronary syndrome. Further study of pharmacologic and mechanical treatments to prevent progression of these lesions is needed.
KW - Percutaneous Coronary Interventions
KW - Saphenous vein grafts
KW - Stents
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U2 - 10.1016/j.ijcard.2013.03.006
DO - 10.1016/j.ijcard.2013.03.006
M3 - Article
C2 - 23561918
AN - SCOPUS:84885653004
SN - 0167-5273
VL - 168
SP - 2468
EP - 2473
JO - International Journal of Cardiology
JF - International Journal of Cardiology
IS - 3
ER -