Ten-year outcomes after percutaneous coronary intervention of in-stent restenosis in saphenous vein grafts.
drug-coated balloon
drug-eluting stent
in-stent restenosis
saphenous vein graft
Journal
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
ISSN: 1522-726X
Titre abrégé: Catheter Cardiovasc Interv
Pays: United States
ID NLM: 100884139
Informations de publication
Date de publication:
Oct 2023
Oct 2023
Historique:
revised:
25
07
2023
received:
19
04
2023
accepted:
06
08
2023
pubmed:
22
8
2023
medline:
22
8
2023
entrez:
22
8
2023
Statut:
ppublish
Résumé
Only few data is available for long-term outcomes of patients being treated for in-stent restenosis (ISR) in saphenous vein grafts (SVG). Thus, the aim of this observational, retrospective study was to close this lack of evidence. Between January 2007 and February 2021 a total of 163 patients with 186 ISR lesions located in SVG were treated at two large-volume centers in Munich, Germany. Endpoints of interest were all-cause mortality, target lesion revascularization (TLR) and target vessel myocardial infarction (TVMI). Furthermore, recurrent ISR were assessed. Outcomes are presented as Kaplan-Meier event rates. Mean age was 72.6 ± 8.6 years, 90.8% were male, 36.8% were diabetics and 42.3% presented an acute coronary syndrome. ISR were treated with DES in 64.0% and with balloon angioplasty (BA) in 36.0%. After 10 years, the rates for all-cause mortality, TVMI and TLR were 58.2%, 15.4%, and 22.6%, respectively. No statistically relevant differences were found between the types of treatment (DES or BA) regarding all-cause mortality (55.7% vs. 63.2%, p = 0.181), TVMI (13.8% vs. 18.6%, p = 0.215) and TLR (21.8% vs. 25.0%, p = 0.764). Median time between first and recurrent ISR was 270.8 days. Recurrent ISR were treated with DES in a comparable proportion as during first ISR (p = 0.075). Independent predictor of TLR is patient age (p = 0.034). The median follow-up duration was 5.1 years (75% CI 2.8; 8.5). Clinical event rates after intervention of ISR located in SVG are high without statistically relevant differences regarding the type of treatment. However, further studies are needed.
Sections du résumé
BACKGROUND
BACKGROUND
Only few data is available for long-term outcomes of patients being treated for in-stent restenosis (ISR) in saphenous vein grafts (SVG).
AIMS
OBJECTIVE
Thus, the aim of this observational, retrospective study was to close this lack of evidence.
METHODS
METHODS
Between January 2007 and February 2021 a total of 163 patients with 186 ISR lesions located in SVG were treated at two large-volume centers in Munich, Germany. Endpoints of interest were all-cause mortality, target lesion revascularization (TLR) and target vessel myocardial infarction (TVMI). Furthermore, recurrent ISR were assessed. Outcomes are presented as Kaplan-Meier event rates.
RESULTS
RESULTS
Mean age was 72.6 ± 8.6 years, 90.8% were male, 36.8% were diabetics and 42.3% presented an acute coronary syndrome. ISR were treated with DES in 64.0% and with balloon angioplasty (BA) in 36.0%. After 10 years, the rates for all-cause mortality, TVMI and TLR were 58.2%, 15.4%, and 22.6%, respectively. No statistically relevant differences were found between the types of treatment (DES or BA) regarding all-cause mortality (55.7% vs. 63.2%, p = 0.181), TVMI (13.8% vs. 18.6%, p = 0.215) and TLR (21.8% vs. 25.0%, p = 0.764). Median time between first and recurrent ISR was 270.8 days. Recurrent ISR were treated with DES in a comparable proportion as during first ISR (p = 0.075). Independent predictor of TLR is patient age (p = 0.034). The median follow-up duration was 5.1 years (75% CI 2.8; 8.5).
CONCLUSIONS
CONCLUSIONS
Clinical event rates after intervention of ISR located in SVG are high without statistically relevant differences regarding the type of treatment. However, further studies are needed.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
646-654Informations de copyright
© 2023 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC.
Références
Robert A, Byrne MJ, Kastrati Adnan. Stent thrombosis and restenosis: what have we learned and where are we going? The Andreas Grüntzig Lecture ESC 2014. Eur Heart J. 2015;36:3320-3331.
Alfonso F, Byrne RA, Rivero F, Kastrati A. Current treatment of in-stent restenosis. JACC. 2014;63:2659-2673. doi:10.1016/j.jacc.2014.02.545
Cassese S, Byrne RA, Tada T, et al. Incidence and predictors of restenosis after coronary stenting in 10 004 patients with surveillance angiography. Heart. 2014;100:153-159. doi:10.1136/heartjnl-2013-304933
Kufner S, Joner M, Thannheimer A, et al. Ten-year clinical outcomes from a trial of three limus-eluting stents with different polymer coatings in patients with coronary artery disease. Circulation. 2019;139:325-333. doi:10.1161/CIRCULATIONAHA.118.038065
Cassese S, Byrne RA, Schulz S, et al. Prognostic role of restenosis in 10 004 patients undergoing routine control angiography after coronary stenting. Eur Heart J. 2015;36:94-99. doi:10.1093/eurheartj/ehu383
Brilakis ES, Lee M, Mehilli J, et al. Saphenous vein graft interventions. Curr Treat Options Cardiovasc Med. 2014;16:301. doi:10.1007/s11936-014-0301-x
Brilakis ES, Wang TY, Rao SV, et al. Frequency and predictors of drug-eluting stent use in saphenous vein bypass graft percutaneous coronary interventions. JACC Cardiovasc Interv. 2010;3:1068-1073. doi:10.1016/j.jcin.2010.07.009
Banerjee S, Brilakis ES. Embolic protection during saphenous vein graft interventions. J Invasive Cardiol. 2009;21:415-417.
Brilakis E, Saeed B, Banerjee S. Drug-eluting stents in saphenous vein graft interventions: a systematic review. EuroIntervention. 2010;5:722-730. doi:10.4244/eijv5i6a119
Abdel-Karim AR, Banerjee S, Brilakis ES. Percutaneous intervention of acutely occluded saphenous vein grafts: contemporary techniques and outcomes. J Invasive Cardiol. 2010;22:253-257.
Nguyen TT, O'Neill WW, Grines CL, et al. One-year survival in patients with acute myocardial infarction and a saphenous vein graft culprit treated with primary angioplasty. Am J Cardiol. 2003;91:1250-1254. doi:10.1016/s0002-9149(03)00277-7
Keeley EC, Velez CA, O'Neill WW, Safian RD. Long-term clinical outcome and predictors of major adverse cardiac events after percutaneous interventions on saphenous vein grafts. JACC. 2001;38:659-665. doi:10.1016/s0735-1097(01)01420-6
Bello SO, Peng EW, Sarkar PK. Conduits for coronary artery bypass surgery: the quest for second best. J Cardiovasc Med. 2011;12:411-421. doi:10.2459/JCM.0b013e328345a20d
Harskamp RE, Lopes RD, Baisden CE, de Winter RJ, Alexander JH. Saphenous vein graft failure after coronary artery bypass surgery: pathophysiology, management, and future directions. Ann Surg. 2013;257:824-833. doi:10.1097/SLA.0b013e318288c38d
Tatoulis J, Buxton BF, Fuller JA. Patencies of 2127 arterial to coronary conduits over 15 years. Ann Thorac Surg. 2004;77:93-101. doi:10.1016/s0003-4975(03)01331-6
Guida G, Ward AO, Bruno VD, et al. Saphenous vein graft disease, pathophysiology, prevention, and treatment. A review of the literature. J Card Surg. 2020;35:1314-1321. doi:10.1111/jocs.14542
Neumann FJ, Sousa-Uva M, Ahlsson A, et al. 2018 ESC/EACTS guidelines on myocardial revascularization. Kardiol Pol. 2018;76:1585-1664. doi:10.5603/KP.2018.0228
Thygesen K, Alpert JS, Jaffe AS, et al. Third universal definition of myocardial infarction. Circulation. 2012;126:2020-2035. doi:10.1161/CIR.0b013e31826e1058
Cutlip DE, Windecker S, Mehran R, et al. Clinical end points in coronary stent trials: a case for standardized definitions. Circulation. 2007;115:2344-2351. doi:10.1161/CIRCULATIONAHA.106.685313
Garcia-Garcia HM, McFadden EP, Farb A, et al. Standardized end point definitions for coronary intervention trials: the academic research consortium-2 consensus document. Circulation. 2018;137:2635-2650. doi:10.1161/CIRCULATIONAHA.117.029289
Magee MJ, Alexander JH, Hafley G, et al. Coronary artery bypass graft failure after on-pump and off-pump coronary artery bypass: findings from PREVENT IV. Ann Thorac Surg. 2008;85:494-500. doi:10.1016/j.athoracsur.2007.10.008
Morrison DA, Sethi G, Sacks J, et al. Percutaneous coronary intervention versus repeat bypass surgery for patients with medically refractory myocardial ischemia. JACC. 2002;40:1951-1954. doi:10.1016/s0735-1097(02)02560-3
Brilakis ES, Rao SV, Banerjee S, et al. Percutaneous coronary intervention in native arteries versus bypass grafts in prior coronary artery bypass grafting patients. JACC Cardiovasc Interv. 2011;4:844-850. doi:10.1016/j.jcin.2011.03.018
Brilakis ES, O'Donnell CI, Penny W, et al. Percutaneous coronary intervention in native coronary arteries versus bypass grafts in patients with prior coronary artery bypass graft surgery. JACC Cardiovasc Interv. 2016;9:884-893. doi:10.1016/j.jcin.2016.01.034
Roleder T, Pociask E, Wańha W, et al. Optical coherence tomography of de novo lesions and in-stent restenosis in coronary saphenous vein grafts (OCTOPUS Study). Circ J. 2016;80:1804-1811. doi:10.1253/circj.CJ-16-0332
Ali ZA, Roleder T, Narula J, et al. Increased thin-cap neoatheroma and periprocedural myocardial infarction in drug-eluting stent restenosis: multimodality intravascular imaging of drug-eluting and bare-metal stents. Circ Cardiovasc Interv. 2013;6:507-517. doi:10.1161/CIRCINTERVENTIONS.112.000248
Kufner S, Ernst M, Cassese S, et al. 10-year outcomes from a randomized trial of polymer-free versus durable polymer drug-eluting coronary stents. JACC. 2020;76:146-158. doi:10.1016/j.jacc.2020.05.026
Kufner S, Cassese S, Valeskini M, et al. Long-term efficacy and safety of paclitaxel-eluting balloon for the treatment of drug-eluting stent restenosis. JACC Cardiovasc Interv. 2015;8:877-884. doi:10.1016/j.jcin.2015.01.031
Tamez H, Secemsky EA, Valsdottir LR, et al. Long-term outcomes of percutaneous coronary intervention for in-stent restenosis among Medicare beneficiaries. EuroIntervention. 2021;17:e380-e387. doi:10.4244/EIJ-D-19-01031
Giacoppo D, Alfonso F, Xu B, et al. Paclitaxel-coated balloon angioplasty vs. drug-eluting stenting for the treatment of coronary in-stent restenosis: a comprehensive, collaborative, individual patient data meta-analysis of 10 randomized clinical trials (DAEDALUS study). Eur Heart J. 2020;41:3715-3728. doi:10.1093/eurheartj/ehz594
Jensen CJ, Richardt G, Tölg R, et al. Angiographic and clinical performance of a paclitaxel-coated balloon compared to a second-generation sirolimus-eluting stent in patients with in-stent restenosis: the BIOLUX randomised controlled trial. EuroIntervention. 2018;14:1096-1103. doi:10.4244/EIJ-D-17-01079
Wong YTA, Kang DY, Lee JB, et al. Comparison of drug-eluting stents and drug-coated balloon for the treatment of drug-eluting coronary stent restenosis: a randomized RESTORE trial. Am Heart J. 2018;197:35-42. doi:10.1016/j.ahj.2017.11.008