In-Stent Restenosis in Saphenous Vein Grafts (from the DIVA Trial)

Am J Cardiol. 2022 Jan 1:162:24-30. doi: 10.1016/j.amjcard.2021.09.024. Epub 2021 Nov 1.

Abstract

Saphenous vein grafts (SVGs) have high rates of in-stent restenosis (ISR). We compared the baseline clinical and angiographic characteristics of patients and lesions that did develop ISR with those who did not develop ISR during a median follow-up of 2.7 years in the DIVA study (NCT01121224). We also examined the ISR types using the Mehran classification. ISR developed in 119 out of the 575 DIVA patients (21%), with similar incidence among patients with drug-eluting stents and bare-metal stents (BMS) (21% vs 21%, p = 0.957). Patients in the ISR group were younger (67 ± 7 vs 69 ± 8 years, p = 0.04) and less likely to have heart failure (27% vs 38%, p = 0.03) and SVG lesions with Thrombolysis In Myocardial Infarction 3 flow before the intervention (77% vs 83%, p <0.01), but had a higher number of target SVG lesions (1.33 ± 0.64 vs 1.16 ± 0.42, p <0.01), more stents implanted in the target SVG lesions (1.52 ± 0.80 vs 1.31 ± 0.66, p <0.01), and longer total stent length (31.37 ± 22.11 vs 25.64 ± 17.42 mm, p = 0.01). The incidence of diffuse ISR was similar in patients who received drug-eluting-stents and BMS (57% vs 54%, p = 0.94), but BMS patients were more likely to develop occlusive restenosis (17% vs 33%, p = 0.05).

Publication types

  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Age Factors
  • Aged
  • Coronary Angiography
  • Coronary Artery Bypass / adverse effects*
  • Coronary Artery Disease / complications
  • Coronary Artery Disease / mortality
  • Coronary Artery Disease / surgery*
  • Coronary Restenosis / diagnosis
  • Coronary Restenosis / epidemiology*
  • Drug-Eluting Stents / adverse effects*
  • Female
  • Graft Occlusion, Vascular / diagnosis
  • Graft Occlusion, Vascular / epidemiology*
  • Humans
  • Male
  • Middle Aged
  • Prosthesis Design
  • Risk Factors
  • Saphenous Vein / transplantation*

Associated data

  • ClinicalTrials.gov/NCT01121224