PURPOSE: In this era of drug eluting stents(DES), the long term outcome of percutaneous intervention (PCI) on saphenous vein grafts (SVGs) is unknown. The objective of the study was to compare the long term outcomes of DES vs. bare metal stent (BMS) in this population and to determine the predictors of outcome.
METHODS: We evaluated all patients who had PCI done from January 2003 to February 2005 to obtain data regarding PCI on SVG, cardiac risk factors, medications at discharge, angiographic details and outcomes.
RESULTS: Over a mean follow up of 33 months, the PCI on bypass graft using DES was associated with 30% restenosis, 35% target vessel revascularization and major adverse cardiac event (MACE) rate of 46% (Table 1) . Smoking was associated with a higher risk of restenosis in graft PCI (hazard ratio = 3.12, p ≤; 0.03) in a multiple logistic regression model which was adjusted for cardiac risk factors, discharge medications and type of stent. There was no significant difference in the long term outcome whether BMS or DES were used. There was a tendency towards higher incidence of late events in DES group (Figure 1).
CONCLUSION: There are significant adverse events associated with PCI of SVGs. Smoking is associated with a higher risk of re-stenosis in graft PCI. Lastly, there is no difference in the long term outcome of PCI on SVG irrespective of the type of stent used.
CLINICAL IMPLICATIONS: This is the first study which provides long term data in regards to PCI of SVGs and value of different types of stents used.
DISCLOSURE: Darpan Bansal, None.