710-3 Stent Placement is Safe and Effective in the Treatment of Older (>4 Years) Saphenous Vein Graft Lesions

Conventional balloon angioplasty (PTCA) in older (>4 years) saphenous vein grafts (SVGs) is associated with reduced procedural success and less favorable late clinical outcomes. To determine if stent (S) implantation neutralizes the adverse effects of SVG age on clinical events, we analyzed the early and late results of 617 consecutive pts from the Palmaz-Schatz SVG S registry. In 69 pts (13.3%), SVG age was ≤4 (mean 2.1±1.3) years and in 448 pts (86.7%), SVG age was >4 (mean 9.9±3.5) years. There were no significant differences in pt demographics and lesion characteristics between the 2 groups. Procedural success was defined as successful S deployment with <50% residual stenosis without major complications (death/Q-wave MI/CABG). Follow-up angiograms were obtained in 63% of pts with SVG≤4 years and in 60% of pts with SVG>4 years. MLD=minimal lumen diameter.SVG Age≤4 yearsSVG Age >4 yearsAngiographic Findings:Final MLD (mm) [% stenosis]3.3±0.7 [7±12]3.4±0.6 [6±10]Follow-up MLD [% stenosis]2.1±1.3 [42±36]2.3±1.3 [33±36]Restenosis (>50% stenosis)35.628.7Clinical Results: 1%)Procedural success97.197.0In hospital death/O-wave MI/CABG14/0/141.7/04/09Follow-up target lesion CABG/PICA57/14354/9.512·month event free survival73.077.0All comparisons between the 2 groups were not statistically significant.In ConclusionAfter S placement, irrespective of SVG age, 1) acute and late angiographic results and restenosis rates were similar and 2) clinical results (i.e. procedural success, major complications, target lesion revascularization and 12-months event free survival) were comparable. Thus, unlike PTCA, in appropriate SVG lesions, the favorable early and 12-month clinical outcomes after S therapy are not diminished by advanced SVG age