Very Late Evaluation of the Use of Drug-Eluting Stents for the Treatment of Patients with Saphenous Vein Graft Lesions: One-Decade Experience of the DESIRE Registry

ABSTRACTBackgroundPercutaneous coronary intervention (PCI) in saphenous vein grafts remains a challenge for interventional cardiology, due to acute complications and the lack of data on the late efficacy of drug-eluting stents (DESs).MethodsBetween May 2002 and January 2013, patients undergoing PCI with DES at Hospital do Coração were included in the DESIRE Registry. We evaluated the results of patients undergoing PCI in saphenous vein grafts (group 1), who were compared to those undergoing PCI in native vessels (group 2.)ResultsOf a total of 4,655 patients, 311 were included in group 1 and 4,344 in group 2. Group 1 included older patients (68.4±9.7years vs. 64±11.2years; P<0.01), more frequently male (87.1% vs. 76.7%; P<0.01) with a higher incidence of comorbidities. Unstable angina was the most frequent clínical presentation in this group. Group 1 patients received large caliber stents (3.18±1.11mm vs. 2.86±0.43mm; P<0.01) and were less frequently submitted to pre-dilation (36.3% vs. 50.7%; P<0.01) and post-dilation (38.3% vs. 58.4%; P<0.01). They had a higher incidence of non-fatal acute myocardial infarction during hospitalization (11.3% vs. 4.1%; P<0.01) and late major adverse cardiovascular events (32.8% vs. 13.9%; P<0.01), at the expense of cardiac death (7.7% vs. 3.2%; P=0.02) and target-lesion revascularization (9% vs. 4.3%; P<0.01). Definitive stent thrombosis was more frequent in group 1 (3.5% vs. 1%; P