Prevalence and outcomes of intermediate saphenous vein graft lesions: Findings from the stenting of saphenous vein grafts randomized-controlled trial

• Published in: International journal of cardiology Vol. 168; no. 3; pp. 2468 - 2473
• Main Authors: Abdel-karim, Abdul-rahman R, Da Silva, Monica, Lichtenwalter, Christopher, de Lemos, James A, Obel, Owen, Addo, Tayo, Roesle, Michele, Haagen, Donald, Rangan, Bavana V, Makke, Lorenza, Jeroudi, Omar M, Raghunathan, Deepa, Saeed, Bilal, Bissett, Joseph K, Sachdeva, Rajesh, Voudris, Vassilios V, Karyofillis, Panagiotis, Kar, Biswajit, Rossen, James, Fasseas, Panayotis, Berger, Peter, Banerjee, Subhash, Brilakis, Emmanouil S
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 03.10.2013; Elsevier
• Subjects: Acute Coronary Syndrome - epidemiology; Aged; Biological and medical sciences; Cardiology. Vascular system; Cardiovascular; Coronary heart disease; Disease Progression; Diseases of the cardiovascular system; Female; Heart; Humans; Male; Medical sciences; Middle Aged; Percutaneous Coronary Interventions; Postoperative Complications - epidemiology; Prevalence; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Saphenous Vein - transplantation; Saphenous vein grafts; Stents; High Density Lipoprotein; SVG; Low Density Lipoprotein; Saphenous vein grafts; Stenting Of Saphenous vein grafts trial; Percutaneous Coronary Interventions; Coronary Artery Bypass Graft; HDL; Saphenous Vein Graft; LDL; SOS; PCI; CABG; Stents; Percutaneous Coronary Intervention; Prognosis; Prevalence; Angioplasty; Cardiovascular disease; Epidemiology; Stent; Percutaneous route; Randomization; Surgery; Clinical trial; Evolution; Graft; Cardiology; Endoprosthesis; Atherectomy; Coronary artery; Instrumentation therapy; Instrumental dilatation; Coronary heart disease; Randomized controlled trial; Saphenous vein; Lesion
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2013.03.006

Abstract Background We sought to examine the prevalence and progression rate of intermediate saphenous vein graft (SVG) lesions in the Stenting Of Saphenous vein grafts (SOS) trial. Methods The baseline and follow-up angiograms of 80 patients participating in the SOS trial were analyzed to determine the prevalence of intermediate (30–60% angiographic diameter stenosis) SVG lesions and their progression rate. Results At least one intermediate SVG lesion was present in 31 of 143 (22%) SVGs in 27 of 80 (34%) patients. Most intermediate lesions were present in the SOS stented SVGs (20 grafts in 19 patients). During a median follow-up of 35 months, angiographic follow-up was available for 28 grafts in 25 patients. Progression (defined as percent diameter stenosis ≥ 70% but < 100% at follow-up angiography) was seen in 11 of 28 SVGs (39%) in 11 of 25 patients (44%). Progression rate at 12, 24 and 36 months was 28% and 47% and 84%, respectively. Seven of 11 patients (64%) with intermediate SVG lesion progression presented with an acute coronary syndrome and 8 (73%) underwent PCI. Four of the 28 grafts with intermediate lesions at baseline were 100% occluded at follow-up; all of those SVGs had received a stent in another location in the SVG as part of the SOS trial. Conclusions Intermediate SVG lesions are common in patients undergoing SVG stenting, have high rates of progression and frequently present with an acute coronary syndrome. Further study of pharmacologic and mechanical treatments to prevent progression of these lesions is needed.