TY - JOUR
T1 - Ten-year outcomes after percutaneous coronary intervention of in-stent restenosis in saphenous vein grafts
AU - Kuna, Constantin
AU - Wiedenmayer, Nadine
AU - Bradaric, Christian
AU - Presch, Antonia
AU - Voll, Felix
AU - Kufner, Sebastian
AU - Ibrahim, Tareq
AU - Schunkert, Heribert
AU - Laugwitz, Karl Ludwig
AU - Cassese, Salvatore
AU - Kastrati, Adnan
AU - Wiebe, Jens
N1 - Publisher Copyright:
© 2023 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC.
PY - 2023/10/1
Y1 - 2023/10/1
N2 - Background: Only few data is available for long-term outcomes of patients being treated for in-stent restenosis (ISR) in saphenous vein grafts (SVG). Aims: Thus, the aim of this observational, retrospective study was to close this lack of evidence. Methods: Between January 2007 and February 2021 a total of 163 patients with 186 ISR lesions located in SVG were treated at two large-volume centers in Munich, Germany. Endpoints of interest were all-cause mortality, target lesion revascularization (TLR) and target vessel myocardial infarction (TVMI). Furthermore, recurrent ISR were assessed. Outcomes are presented as Kaplan–Meier event rates. Results: Mean age was 72.6 ± 8.6 years, 90.8% were male, 36.8% were diabetics and 42.3% presented an acute coronary syndrome. ISR were treated with DES in 64.0% and with balloon angioplasty (BA) in 36.0%. After 10 years, the rates for all-cause mortality, TVMI and TLR were 58.2%, 15.4%, and 22.6%, respectively. No statistically relevant differences were found between the types of treatment (DES or BA) regarding all-cause mortality (55.7% vs. 63.2%, p = 0.181), TVMI (13.8% vs. 18.6%, p = 0.215) and TLR (21.8% vs. 25.0%, p = 0.764). Median time between first and recurrent ISR was 270.8 days. Recurrent ISR were treated with DES in a comparable proportion as during first ISR (p = 0.075). Independent predictor of TLR is patient age (p = 0.034). The median follow-up duration was 5.1 years (75% CI 2.8; 8.5). Conclusions: Clinical event rates after intervention of ISR located in SVG are high without statistically relevant differences regarding the type of treatment. However, further studies are needed.
AB - Background: Only few data is available for long-term outcomes of patients being treated for in-stent restenosis (ISR) in saphenous vein grafts (SVG). Aims: Thus, the aim of this observational, retrospective study was to close this lack of evidence. Methods: Between January 2007 and February 2021 a total of 163 patients with 186 ISR lesions located in SVG were treated at two large-volume centers in Munich, Germany. Endpoints of interest were all-cause mortality, target lesion revascularization (TLR) and target vessel myocardial infarction (TVMI). Furthermore, recurrent ISR were assessed. Outcomes are presented as Kaplan–Meier event rates. Results: Mean age was 72.6 ± 8.6 years, 90.8% were male, 36.8% were diabetics and 42.3% presented an acute coronary syndrome. ISR were treated with DES in 64.0% and with balloon angioplasty (BA) in 36.0%. After 10 years, the rates for all-cause mortality, TVMI and TLR were 58.2%, 15.4%, and 22.6%, respectively. No statistically relevant differences were found between the types of treatment (DES or BA) regarding all-cause mortality (55.7% vs. 63.2%, p = 0.181), TVMI (13.8% vs. 18.6%, p = 0.215) and TLR (21.8% vs. 25.0%, p = 0.764). Median time between first and recurrent ISR was 270.8 days. Recurrent ISR were treated with DES in a comparable proportion as during first ISR (p = 0.075). Independent predictor of TLR is patient age (p = 0.034). The median follow-up duration was 5.1 years (75% CI 2.8; 8.5). Conclusions: Clinical event rates after intervention of ISR located in SVG are high without statistically relevant differences regarding the type of treatment. However, further studies are needed.
KW - drug-coated balloon
KW - drug-eluting stent
KW - in-stent restenosis
KW - saphenous vein graft
UR - http://www.scopus.com/inward/record.url?scp=85168692517&partnerID=8YFLogxK
U2 - 10.1002/ccd.30807
DO - 10.1002/ccd.30807
M3 - Article
C2 - 37605515
AN - SCOPUS:85168692517
SN - 1522-1946
VL - 102
SP - 646
EP - 654
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
IS - 4
ER -