Contemporary percutaneous treatment of saphenous vein graft stenosis: Immediate and late outcomes

Purpose. The aim of this study was to evaluate the immediate and long-term outcomes following percutaneous treatment of an unselected series of saphen ous vein graft (SVG) lesions. Methods and Results. Consecutive interventions on 129 saphenous vein graft lesions in 101 patients were reviewed. Stents were implanted in 114 lesions (88%), which included the use of polytetrafluoroethylene-covered stents in 22 lesions (17%) and abciximab in 20 patients (20%). Angiographic success was achieved in 125 lesions (97%). In-hospital major adverse cardiac events (MACE) occurred in 11 patients (11%), with myocardial infarction being the most frequent event. Treatment of degenerated SVG lesions and SVG lesions with larger reference diameters correlated with the incidence of in-hospita l MACE [odds ratio (OR) = 7.69 and 2.65, respectively; 95% confidence inter val (CI)= 1.80-32.8 and 0.99-7.10, respectively)]. Clinical follow-up was a chieved in all patients at 25 +/- 21 months. Successful revascularization t o all three distributions of the major coronary arteries negatively correla ted [relative risk (RR)= 0.43; 95% CI = 0.20-0.92)], while treatment of a d egenerated SVG positively correlated (RR = 1.92; 95% CI = 1.05-3.51) with t he occurrence of follow-up MACE. A final effective blood supply to the ante rior wall and a higher left ventricular ejection fraction was found to nega tively correlate with the occurrence of follow-up death (RR = 0.20 and 0.61 , respectively; 95% CI = 0.06-0.60 and 0.41-0.90, respectively). Conclusion. Treatment of SVG lesions continues to be associated with a high incidence of myocardial infarction, particularly in cases of degenerated S VG lesions. An effective blood supply to the anterior wall and a higher lef t ventricular ejection fraction were protective for the occurrence of death during the follow-up period.