Outcome of Saphenous Vein Graft Percutaneous Coronary Intervention Using Contemporary Drug-Eluting Stents : A SCAAR Report
(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.
(Less)
- author
- Saidi-Seresht, Saman
; James, Stefan
; Erlinge, David
LU
; Koul, Sasha LU ; Lagerqvist, Bo ; Mohammad, Moman LU
; Renlund, Henrik and Grimfjärd, Per
- organization
- publishing date
- 2024-10
- 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}}, }