Long‐term clinical outcomes of real‐world experience using sirolimus‐eluting stents in saphenous vein graft disease

Ramana, Ravi K.; Ronan, Adam; Cohoon, Kevin P.; Homan, David; Sutherland, Jessica A.; Steen, Lowell; Liu, Jayson; Loeb, Henry S.; Lewis, Bruce E.

doi:10.1002/ccd.21552

Cited by 37 publications

(24 citation statements)

References 25 publications

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“…Tables 1, 2 and 3 summarize the characteristics of the studies. The other 26 studies (n = 7347) were observational registries [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [32], [33], [34], [35], [36], [37], [38], [39], [40], [41], [42], [43]…”

Section: Resultsmentioning

confidence: 99%

Drug-Eluting versus Bare-Metal Stent for Treatment of Saphenous Vein Grafts: A Meta-Analysis

et al. 2010

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BackgroundSaphenous vein grafts develop an aggressive atherosclerotic process and the efficacy of drug eluting stents (DES) in treating saphenous vein graft (SVG) lesions has not been convincingly demonstrated. The aim of this study was to review and analyze the current literature for controlled studies comparing DES versus bare metal stents (BMS) for treatment of SVG stenoses.Methodology/Principal FindingsWe searched several scientific databases and conference proceedings up to March 15, 2010 for controlled studies comparing target vessel revascularization (TVR) between DES and BMS. Summary odds ratios (OR) for the primary endpoint TVR and secondary endpoints infarction, stent thrombosis and death were calculated using random-effect models. A total of 29 studies (3 randomized controlled trials RCT) involving 7549 (202 in RCT) patients were included. The need for target vessel revascularization in the DES group tended to be lower compared to BMS for the 3 RCT (OR 0.50 [0.24–1.00]; p = 0.051) and for observational studies (0.62 [0.49–0.79]; p<0.001). There was no significant difference in the risk for myocardial infarction in the RCT (OR 1.25 [0.22–6.99]; p = 0.250) but a lower risk for DES based on the observational studies 0.68 [0.49–0.95]; p = 0.023. The risk for stent thrombosis was found to be non-different in the RCT (OR 0.78 [0.03–21.73], p = 0.885) while it was in favor of DES in the observational studies (0.58 [0.38 – 0.84]; p<0.001). The mortality was not significantly different between DES and BMS in the RCT's (OR 2.22 [0.17 – 29.50]; p = 0.546) while the observation studies showed a decreased mortality in the DES group (0.69 [0.55–0.85]; p<0.001).ConclusionDES may decrease TVR rate in treatment of SVG stenoses. No differences in reinfarction rate, stent thrombosis or mortality was found between the DES and BMS groups in the RCT's while the observational data showed lower risk for myocardial infarction, stent thrombosis and death in the DES group. This may be a result of patient selection bias in the observational studies or represent a true finding that was not the detected in the RCT analysis due to limited statistical power.

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Section: Resultsmentioning

confidence: 99%

Drug-Eluting versus Bare-Metal Stent for Treatment of Saphenous Vein Grafts: A Meta-Analysis

et al. 2010

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“…However, there is a paucity of prospective data on DES in SVG interventions, although BMS is associated with high restenosis rates in SVG lesions. The results of mostly retrospective observational series comparing DES with BMS in SVGs have been conflicting: 6 studies showed better results with DES (9 -14) and 9 suggested no difference between BMS and DES (15)(16)(17)(18)(19)(20)(21)(22)(23).…”

Section: Discussionmentioning

confidence: 97%

A Randomized Controlled Trial of a Paclitaxel-Eluting Stent Versus a Similar Bare-Metal Stent in Saphenous Vein Graft Lesions

Brilakis

Lichtenwalter

Lemos

et al. 2009

Journal of the American College of Cardiology

198

139

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“…We used the abstracted MACE as defined by the authors; however, the definition varied among studies. For mortality, some studies used all-cause mortality (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27), whereas others used cardiac mortality (28 -32). Some studies used TVR (20 -22,24 -27,29,32-35), whereas others used TLR (28,30,31,36) or both (18 -20,24,37) in their composite MACE end point.…”

Section: Data Analysis Meta-analysesmentioning

confidence: 99%

Drug-Eluting Stents Versus Bare-Metal Stents in Saphenous Vein Graft Interventions

Wiisanen

Abdel‐Latif

Mukherjee

et al. 2010

JACC: Cardiovascular Interventions

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Long‐term clinical outcomes of real‐world experience using sirolimus‐eluting stents in saphenous vein graft disease

Cited by 37 publications

References 25 publications

Drug-Eluting versus Bare-Metal Stent for Treatment of Saphenous Vein Grafts: A Meta-Analysis

Drug-Eluting versus Bare-Metal Stent for Treatment of Saphenous Vein Grafts: A Meta-Analysis

A Randomized Controlled Trial of a Paclitaxel-Eluting Stent Versus a Similar Bare-Metal Stent in Saphenous Vein Graft Lesions

Drug-Eluting Stents Versus Bare-Metal Stents in Saphenous Vein Graft Interventions

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