Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Oct;102(4):646-654.
doi: 10.1002/ccd.30807. Epub 2023 Aug 21.

Ten-year outcomes after percutaneous coronary intervention of in-stent restenosis in saphenous vein grafts

Constantin Kuna  1 , Nadine Wiedenmayer  1 , Christian Bradaric  2 , Antonia Presch  1 , Felix Voll  1 , Sebastian Kufner  1 , Tareq Ibrahim  2 , Heribert Schunkert  1   3 , Karl-Ludwig Laugwitz  2   3 , Salvatore Cassese  1 , Adnan Kastrati  1   3 , Jens Wiebe  1   3
Affiliations

Ten-year outcomes after percutaneous coronary intervention of in-stent restenosis in saphenous vein grafts

Constantin Kuna et al. Catheter Cardiovasc Interv. 2023 Oct.

Abstract

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.

Keywords: drug-coated balloon; drug-eluting stent; in-stent restenosis; saphenous vein graft.

PubMed Disclaimer

References

REFERENCES

    1. Robert A, Byrne MJ, Kastrati Adnan. Stent thrombosis and restenosis: what have we learned and where are we going? The Andreas Grüntzig Lecture ESC 2014. Eur Heart J. 2015;36:3320-3331.
    1. Alfonso F, Byrne RA, Rivero F, Kastrati A. Current treatment of in-stent restenosis. JACC. 2014;63:2659-2673. doi:10.1016/j.jacc.2014.02.545
    1. Cassese S, Byrne RA, Tada T, et al. Incidence and predictors of restenosis after coronary stenting in 10 004 patients with surveillance angiography. Heart. 2014;100:153-159. doi:10.1136/heartjnl-2013-304933
    1. Kufner S, Joner M, Thannheimer A, et al. Ten-year clinical outcomes from a trial of three limus-eluting stents with different polymer coatings in patients with coronary artery disease. Circulation. 2019;139:325-333. doi:10.1161/CIRCULATIONAHA.118.038065
    1. Cassese S, Byrne RA, Schulz S, et al. Prognostic role of restenosis in 10 004 patients undergoing routine control angiography after coronary stenting. Eur Heart J. 2015;36:94-99. doi:10.1093/eurheartj/ehu383

LinkOut - more resources