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Outcome of Saphenous Vein Graft Percutaneous Coronary Intervention Using Contemporary Drug-Eluting Stents : A SCAAR Report

Saidi-Seresht, Saman ; James, Stefan ; Erlinge, David LU orcid ; Koul, Sasha LU ; Lagerqvist, Bo ; Mohammad, Moman LU orcid ; Renlund, Henrik and Grimfjärd, Per (2024) In Journal of the Society for Cardiovascular Angiography and Interventions 3(10).
Abstract

Background: Percutaneous coronary intervention (PCI) of saphenous vein grafts (SVG) is associated with poor outcomes and is often regarded as inferior to native vessel PCI. We investigated clinical outcomes of SVG-PCI using contemporary drug-eluting stents (DES), in a complete, nationwide population. Methods: The complete Swedish Coronary Angiography and Angioplasty Registry (SCAAR) was used to identify all patients in Sweden who underwent SVG-PCI with a contemporary DES between 2013 and 2020. Baseline characteristics, procedures, and outcomes were described. Results: A total of 2198 SVG-PCI procedures with 3106 contemporary DES were included. Patients had a high incidence of comorbidities such as diabetes (40%), prior myocardial... (More)

Background: Percutaneous coronary intervention (PCI) of saphenous vein grafts (SVG) is associated with poor outcomes and is often regarded as inferior to native vessel PCI. We investigated clinical outcomes of SVG-PCI using contemporary drug-eluting stents (DES), in a complete, nationwide population. Methods: The complete Swedish Coronary Angiography and Angioplasty Registry (SCAAR) was used to identify all patients in Sweden who underwent SVG-PCI with a contemporary DES between 2013 and 2020. Baseline characteristics, procedures, and outcomes were described. Results: A total of 2198 SVG-PCI procedures with 3106 contemporary DES were included. Patients had a high incidence of comorbidities such as diabetes (40%), prior myocardial infarction (MI) (69%), and acute coronary syndrome (74%) at presentation. SVG-PCI procedures commonly involved multiple DES (41%). Native vessel PCI, in addition to SVG-PCI, was performed in only 13% of procedures. At 1 year, adverse clinical outcomes were frequent as exemplified by any death (9.2%), MI (9.1%), or revascularization (21.1%), whereas stent and lesion-related outcomes on a patient level were less common: stent thrombosis (1.2%), in-stent restenosis (4.3%) and target lesion revascularization (4.3%). Similarly, at 3 years, clinical outcomes were frequent: death (19.8%), MI (21.1%), revascularization (32.8%); and stent-related outcomes were less common: stent thrombosis (2.9%), restenosis (10.8), and target lesion revascularization (13.6%). Conclusions: In this nationwide cohort of patients who underwent SVG-PCI with contemporary DES, patients were characterized by a high-risk profile and high rates of adverse clinical events. However, the incidence of stent and lesion-related events was low.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
coronary artery bypass graft surgery, drug-eluting stent, percutaneous coronary intervention, saphenous vein graft
in
Journal of the Society for Cardiovascular Angiography and Interventions
volume
3
issue
10
article number
102232
publisher
Elsevier
external identifiers
  • pmid:39525986
  • scopus:85206619000
ISSN
2772-9303
DOI
10.1016/j.jscai.2024.102232
language
English
LU publication?
yes
id
a49fd840-88c2-4d5f-bace-1423b221c565
date added to LUP
2024-12-16 14:21:37
date last changed
2025-06-17 04:07:41
@article{a49fd840-88c2-4d5f-bace-1423b221c565,
  abstract     = {{<p>Background: Percutaneous coronary intervention (PCI) of saphenous vein grafts (SVG) is associated with poor outcomes and is often regarded as inferior to native vessel PCI. We investigated clinical outcomes of SVG-PCI using contemporary drug-eluting stents (DES), in a complete, nationwide population. Methods: The complete Swedish Coronary Angiography and Angioplasty Registry (SCAAR) was used to identify all patients in Sweden who underwent SVG-PCI with a contemporary DES between 2013 and 2020. Baseline characteristics, procedures, and outcomes were described. Results: A total of 2198 SVG-PCI procedures with 3106 contemporary DES were included. Patients had a high incidence of comorbidities such as diabetes (40%), prior myocardial infarction (MI) (69%), and acute coronary syndrome (74%) at presentation. SVG-PCI procedures commonly involved multiple DES (41%). Native vessel PCI, in addition to SVG-PCI, was performed in only 13% of procedures. At 1 year, adverse clinical outcomes were frequent as exemplified by any death (9.2%), MI (9.1%), or revascularization (21.1%), whereas stent and lesion-related outcomes on a patient level were less common: stent thrombosis (1.2%), in-stent restenosis (4.3%) and target lesion revascularization (4.3%). Similarly, at 3 years, clinical outcomes were frequent: death (19.8%), MI (21.1%), revascularization (32.8%); and stent-related outcomes were less common: stent thrombosis (2.9%), restenosis (10.8), and target lesion revascularization (13.6%). Conclusions: In this nationwide cohort of patients who underwent SVG-PCI with contemporary DES, patients were characterized by a high-risk profile and high rates of adverse clinical events. However, the incidence of stent and lesion-related events was low.</p>}},
  author       = {{Saidi-Seresht, Saman and James, Stefan and Erlinge, David and Koul, Sasha and Lagerqvist, Bo and Mohammad, Moman and Renlund, Henrik and Grimfjärd, Per}},
  issn         = {{2772-9303}},
  keywords     = {{coronary artery bypass graft surgery; drug-eluting stent; percutaneous coronary intervention; saphenous vein graft}},
  language     = {{eng}},
  number       = {{10}},
  publisher    = {{Elsevier}},
  series       = {{Journal of the Society for Cardiovascular Angiography and Interventions}},
  title        = {{Outcome of Saphenous Vein Graft Percutaneous Coronary Intervention Using Contemporary Drug-Eluting Stents : A SCAAR Report}},
  url          = {{http://dx.doi.org/10.1016/j.jscai.2024.102232}},
  doi          = {{10.1016/j.jscai.2024.102232}},
  volume       = {{3}},
  year         = {{2024}},
}