Are Drug-Eluting Stents Better Than Bare-Metal Stents in Old or Degenerated Saphenous Vein Grafts?

Results of a randomized trial at 1 year indicate that they are, but long-term clinical benefits remain uncertain.

In small studies of drug-eluting stents (DES) versus bare-metal stents (BMS) for treatment of degenerated aortocoronary saphenous vein grafts (SVGs), DES reduced restenosis; however, the studies were underpowered for clinical outcomes. Now, the ISAR-CABG investigators have randomized 610 patients (average age, 73; 15% women; acute coronary syndromes, 40%) with de novo SVG lesions to receive either DES (one of three types: permanent-polymer paclitaxel-eluting, permanent-polymer sirolimus-eluting, or biodegradable-polymer sirolimus-eluting) or BMS. Mean SVG age was >13 years, and average stent length was approximately 27 mm.

At 1 year, incidence of the primary endpoint of death, myocardial infarction (MI), or target-lesion revascularization (T…

Reviewing Author

Beat J. Meyer, MD

Disclosures

Leadership positions in professional societiesBern Heart Foundation (President); International Academy of Medicine, Bern, Switzerland (Director)

Beat J. Meyer, MD

Disclosures

Leadership positions in professional societiesBern Heart Foundation (President); International Academy of Medicine, Bern, Switzerland (Director)