Saphenous vein graft disease treated with the Wiktor Hepamed stent: Procedural outcome, in-hospital complications and six-month angiographic follow-up

OBJECTIVES: To evaluate the effectiveness of electively placed heparin-coat ed stents in the treatment of coronary saphenous vein bypass grafts with de novo lesions less than 15 mm in diameter in a prospective study with all e ligible consecutive patients presenting to Middelheim Hospital, Antwerp, Be lgium between September 1997 and August 1998. PATIENTS AND METHODS: Fifty patients with 53 lesions were studied. Anginal class, risk factors, quantitative coronary angiographic measurements pre- a nd postprocedure, procedural outcome, in-hospital events, clinical status o n discharge, and six-month clinical and angiographic follow-up (in 48 patie nts) were recorded. All patients received acetylsalicylic acid and ticlopid ine, unless known intolerance was present. RESULTS: On average, 1.1 stents/patient were placed in very old saphenous v ein grafts (11.7+/-3.9 years). Procedural success was 98%. Only two non-Q w ave myocardial infarctions (MIs) occurred, with no Q-wave MIs and no deaths during hospital stay. Length of hospital stay was short (2.4+/-1.7 days), and 96% of patients were free of angina on discharge. At six-months' follow -up, two patients had died, one of whom died of a noncardiac cause. One pat ient suffered a non-Q wave MI. At six months, 86% of patients were free fro m angina. Minimal luminal diameter decreased from 1.14 mm before to 3.33 mm after stenting and to 2.52 mm at six months. Restenosis was present in 22% of patients (21.6% of lesions). CONCLUSIONS: In a selected population with coronary saphenous vein bypass g raft disease, Wiktor heparin-coated stents can be delivered with an excelle nt periprocedural outcome. Six-month outcome appears favourable with a low recurrence of angina (18%) and a low rate of angiographic restenosis (21.6% ).