Publikationsserver der RWTH Aachen University
Vergleichende Untersuchung zur Nutzung von Paclitaxel-beschichteten-Stents und unbeschichteten Stents zur Behandlung stenosierter Venenbypässe
Abstract
dc:descriptionOBJECTIVE: There is little data on the clinical and angiographic success of drug-eluting stents in saphenous vein grafts. This multicenter study sought to define the follow-up clinical and angiographic results after implantation of paclitaxel-eluting stents (PES) in stenotic saphenous vein grafts in comparison to treatment using bare metal stents (BMS). METHODS: 60 patients (67±11 years, 54 male) with 65 lesions located in 65 saphenous vein grafts (mean age of vein grafts 11.3±5.7 years) treated with PES (V-Flex Plus®, 2.7µg/mm2 paclitaxel, Cook Inc) and 60 patients (66±12 years, 52 male) with 60 saphenous vein graft lesions treated with BMS were included in the study. Lesions had to be less than 20 mm in length and in saphenous vein grafts of 2.75 to 3.5 mm diameter. Angiographic follow-up was obtained on 51 lesions (79%) of the PES group and 51 lesions (85%) of the BMS group. RESULTS: Baseline clinical and angiographic characteristics were comparable between both groups with lesion lengths of 11.8±4.1 and 10.8±3.8 mm (P=ns) and reference vessel diameters of 3.05±0.52 and 3.06±0.60 mm (P=ns) in the PES and the BMS groups, respectively. At angiographic follow-up 3 vein grafts in the PES group and 5 vein grafts in the BMS group were occluded. Implantation of non-polymer based PES resulted in an in-stent late lumen loss which was lower compared to BMS (0.61±0.81 vs. 1.06±0.72 mm, respectively, P=0.021). In-stent binary restenosis rates were 12 vs 33%, respectively, (P=0.012). In a linear regression analysis stent being a BMS was found to be the only parameter with impact on late lumen loss (P=0.011). Target vessel failure rates were 14% in the PES and 35% in the BMS group (P=0.011) while MACE rates at 180 days were 15% and 37%, respectively (P=0.006).CONCLUSION: Implantation of non-polymer based PES in new saphenous vein graft lesions is associated with a lower late loss and restenosis rate compared to those of BMS. However, there remains a substantial target vessel failure rate and MACE rate even at 6 months due to graft occlusion or new lesions within the graft.
Degree
thesis:*- Grantor dc:publisher
- Publikationsserver der RWTH Aachen University
- Year dc:date
- 2008
Author and committee
dc:creator, dc:contributor.*- Author dc:creator
-
- Lotfipour, Khosrow
- Contributors dc:contributor
-
- Hoffmann, Rainer
Subjects
dc:subject × 6Rights
dc:rights- Statement dc:rights
-
- info:eu-repo/semantics/openAccess
- Language dc:language
- ger