Secondary prevention, the interventional way: prophylactic drug-eluting stents for nonobstructive saphenous vein graft disease.

نویسندگان

  • Sahil A Parikh
  • Marco A Costa
چکیده

The pathophysiology of accelerated atherosclerosis in saphenous vein grafts (SVG) relates to progressive atheroma burden, neointimal hyperplasia, and vascular remodeling.1,2 Unfortunately, the therapeutic and clinical consequences of SVG disease are not trivial, and interventional cardiologists are wary of performing percutaneous coronary interventions (PCI) on degenerated SVG. Intervening on flow-limiting stenoses in SVG has long been associated with high complication rates;3 what was not well known to this date was the risk of stenting non–flow-limiting disease in SVG.4 Although techniques to mitigate distal embolization during SVG intervention have proliferated in the past decade, even optimal intervention with embolic protection devices, including proximal protection devices, filters, aspiration tools, and covered stents, have attendant higher complication rates than does native vessel PCI.5 Drug-eluting stents (DES) are of benefit in reducing restenosis compared with bare metal stents in SVG, but clinical adverse events are only marginally reduced, if at all.6–8

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منابع مشابه

Sealing Intermediate Nonobstructive Coronary Saphenous Vein Graft Lesions With Drug-Eluting Stents as a New Approach to Reducing Cardiac Events: A Randomized Controlled Trial.

BACKGROUND The objective of this study was to assess the efficacy of sealing intermediate nonobstructive coronary saphenous vein graft (SVG) lesions with drug-eluting stents (DES; paclitaxel- or everolimus-eluting stents) for reducing major adverse cardiac events (MACE). METHODS AND RESULTS This was a randomized controlled multicenter clinical trial that enrolled patients with a previous coro...

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Advances in vein graft intervention

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عنوان ژورنال:
  • Circulation

دوره 120 20  شماره 

صفحات  -

تاریخ انتشار 2009