COMPARISON OF STENTING AND BALLOON ANGIOPLASTY FOR NARROWINGS IN AORTOCORONARY SAPHENOUS-VEIN CONDUITS IN-PLACE FOR MORE THAN 5 YEARS

To compare the 1 year outcome of Palmaz-Schatz stent implantation vers us balloon angioplasty for treatment of obstructive lesions in sapheno us vein grafts, we combined databases from the Palmaz-Schatz vein graf t stent registry and the coronary angioplasty arm of the Coronary Angi oplasty Versus Excisional Atherectomy Trial II (CAVEAT II) for compari son of baseline characteristics, procedural variables, in-hospital eve nts and 1-year composite end point of death, Q-wave myocardial infarct ion, and repeat target vessel revascularization. De novo graft lesions not involving the ostia were treated with stent implantation in 377 p atients and with coronary angioplasty in 156 patients. The patients we re comparable in age, coronary risk profile, interval from bypass surg ery (9 +/- 4 years), and reference vessel diameter. The in-hospital co mposite end point of death, myocardial infarction, and emergency revas cularization was lower in the stent group (10%) than in the angioplast y cohort (17%) (p = 0.059). At 1 year, the patients in the stent group had a markedly lower incidence of the composite end point of death, m yocardial infarction, or revascularization (23% vs 45%, p < 0.001). In this nonrandomized comparison with balloon angioplasty, the treatment of lesions in saphenous vein grafts appears to be favorably influence d by Palmaz-Schatz stent implantation, in terms of in-hospital events and clinical restenosis at 1 year follow-up. (C) 1997 by Excerpta Medi ca, Inc.