A Randomized Controlled Trial of a Paclitaxel-Eluting Stent Versus a Similar Bare-Metal Stent in Saphenous Vein Graft Lesions : The SOS (Stenting Of Saphenous Vein Grafts) Trial

The aim of this study was to compare the frequency of angiographic restenosis and clinical events between a paclitaxel-eluting stent (PES) and a similar bare-metal stent (BMS) in saphenous vein graft (SVG) lesions. There are conflicting and mostly retrospective data on outcomes after drug-eluting st...

Full description

Saved in:
Bibliographic Details
Published in:Journal of the American College of Cardiology 2009-03, Vol.53 (11), p.919-928
Main Authors: BRILAKIS, Emmanouil S, LICHTENWALTER, Christopher, VOUDRIS, Vassilios V, KARYOFILLIS, Panagiotis, KAR, Biswajit, ROSSEN, James, FASSEAS, Panayotis, BERGER, Peter, BANERJEE, Subhash, DE LEMOS, James A, ROESLE, Michele, OBEL, Owen, HAAGEN, Donald, SAEED, Bilal, GADIPARTHI, Chiranjeevi, BISSETT, Joseph K, SACHDEVA, Rajesh
Format: Article
Language:English
Subjects:
Aged
Angioplasty
Biological and medical sciences
Cardiology
Cardiology. Vascular system
Coronary Angiography
Coronary Artery Disease - surgery
Coronary Restenosis - diagnostic imaging
Coronary Restenosis - epidemiology
Coronary Restenosis - prevention & control
Diseases of the cardiovascular system
Drug-Eluting Stents
Female
Heart attacks
Humans
Male
Medical sciences
Middle Aged
Paclitaxel - administration & dosage
Platelet Aggregation Inhibitors - administration & dosage
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Saphenous Vein - transplantation
Stents
Ticlopidine - administration & dosage
Ticlopidine - analogs & derivatives
Veins & arteries
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The aim of this study was to compare the frequency of angiographic restenosis and clinical events between a paclitaxel-eluting stent (PES) and a similar bare-metal stent (BMS) in saphenous vein graft (SVG) lesions. There are conflicting and mostly retrospective data on outcomes after drug-eluting stent implantation in SVGs. Patients requiring SVG lesion stenting were randomized to BMS or PES. The primary study end point was binary in-segment restenosis at 12-month follow-up quantitative coronary angiography. Secondary end points included death, myocardial infarction, ischemia-driven target vessel and lesion revascularization, and target vessel failure. Eighty patients with 112 lesions in 88 SVGs were randomized to a BMS (39 patients, 43 grafts, 55 lesions) or PES (41 patients, 45 grafts, 57 lesions). Binary angiographic restenosis occurred in 51% of the BMS-treated lesions versus 9% of the PES-treated lesions (relative risk: 0.18; 95% confidence interval [CI]: 0.07 to 0.48, p < 0.0001). During a median follow-up of 1.5 years the PES patients had less target lesion revascularization (28% vs. 5%, hazard ratio: 0.38; 95% CI: 0.15 to 0.74, p = 0.003) and target vessel failure (46% vs. 22%, hazard ratio: 0.65; 95% CI: 0.42 to 0.96, p = 0.03), a trend toward less target vessel revascularization (31% vs. 15%, hazard ratio: 0.66; 95% CI: 0.39 to 1.05, p = 0.08) and myocardial infarction (31% vs. 15%, hazard ratio: 0.67; 95% CI: 0.40 to 1.08, p = 0.10), and similar mortality (5% vs. 12%, hazard ratio: 1.56; 95% CI: 0.72 to 4.11, p = 0.27). In SVG lesions, PES are associated with lower rates of angiographic restenosis and target vessel failure than BMS.
ISSN:0735-1097
1558-3597
DOI:10.1016/j.jacc.2008.11.029