In stent restenosis of venous bypass grafts

Follow-up studies after stent implantation of native coronary arteries have reported reduced rates of angiographic restenosis. In contrast, stent impl antation in the treatment of obstructive disease of coronary artery bypass grafts is complicated by higher restenosis rates. We sought to determine, i f different predictors contribute to the high restenosis rate following ste nt implantation of coronary artery bypass grafts. We investigated longterm angiographic outcome of 205 stent implantations performed in 177 patients. Multivariate analysis correlated clinical, procedural and angiographic vari ables with the incidence of angiographic restenosis defined as diameter ste nosis >50% at follow-up. Angiographic restenosis was observed in 34% of les ions treated. Multiple logistic regression analysis defined diabetes mellit us (OR 6.89, CI 2.41-9.69), graft recanalization (OR 2.69, CI 1.08-6.63), l esion at the aortic anastomosis (OR 6.98, CI 2.76-19.25), lesion at the cor onary anastomosis (OR 2.95, CI 1.18-7.49), high diameter stenosis after ste nt placement (OR 7.01, CI 2.64-15.71), placement of long stents (OR 2.78, C I 1.11-7.36) and implantation of more than one stent (OR 7.34, CI 2.08-20.1 5) as independent predictors of graft in-stent restenosis. Critical conside ration of these variables may help to identify patients who are poor candid ates for stent implantation and who may benefit from different intervention al approaches.