Treatment of Aortocoronary Vein Graft Lesions With Membrane-Covered Stents

Abstract

Background —Stent implantation in lesions of degenerated aortocoronary vein grafts is associated with a high risk of periprocedural thrombus embolization and in-stent restenosis. Methods and Results —In a multicenter study, we followed up 109 consecutive patients (mean age 66±8 years, 12% female) who received polytetrafluoroethylene (PTFE) membrane–covered stents for 125 de novo stenoses in vein grafts 11±5 years after bypass surgery. Stent deployment was successful in all but 1 patient; 1 patient suffered from subacute stent thrombosis. Six-month cardiac mortality was 7% (8 patients), 3 patients (3%) underwent repeat bypass surgery, and 9 patients (8%) required target-lesion PTCA. Repeat angiography revealed vessel occlusions in 9% and in-stent restenosis in 8% of patients by the end of follow-up. Conclusions —Membrane-covered stents appear to be a safe and efficient treatment strategy associated with a low incidence of restenosis and target-vessel revascularization. Compared with previous studies, the investigated device is not associated with an increase in mortality or late vessel occlusions.