Immediate and long-term results comparing coronary versus biliary tubular-slotted stents to treat old obstructed saphenous vein grafts

Stenting of old obstructed saphenous vein grafts improves immediate angiogr aphic results and long-term clinical outcome compared to standard balloon a ngioplasty. Comparison of results and long-term clinical outcome between di fferent types of stents in the treatment of vein graft disease is scarce. T he authors studied two matched groups of 33 patients each, receiving either coronary or biliary tubular-slotted stents in old vein graft lesions to co mpare immediate results and long-term clinical outcome. Patients in the two groups were matched for age and left ventricular function. Baseline angiog raphic characteristics, the minimal luminal diameter (MLD) (0.68 +/- 0.56 m m vs 0.61 +/- 0.51 mm, p = 0.9), and diameter stenosis (DS) (81 +/- 14% vs 82 +/- 15%) were similar between the groups. After stenting, the MLD (3.15 +/- 0.65 mm vs 3.37 +/- 0.63 mm, p = 0.9) and residual stenosis (-7 +/- 19% vs -11 +/- 21%) were also similar. The in-hospital major complications (my ocardial infarction and death) (one vs eight, p = 0.01) and the combination of major and minor (bleeding and vascular) complications (eight vs 17, p = 0.02) were higher in the biliary stent group. At long-term follow-up, both groups of patients had high but comparable rates of major cardiovascular e vents (39% vs 45%, p = 0.62). Kaplan-Meier event-free survival analysis did not show any statistically significant difference in event-free survival ( log-rank statistic 0.98). The authors conclude that patients receiving bili ary stents had higher rates of immediate minor and major complications, but at long-term follow up, major cardiovascular event rates were comparable b etween the two groups of patients.