Abstract 8423: Prevalence and Outcomes of Intermediate Saphenous Vein Graft Lesions: Findings from the Stenting of Saphenous Vein Grafts Randomized-Controlled Trial
Background: We sought to examine the prevalence and progression rate of intermediate SVG lesions in the Stenting Of Saphenous vein grafts (SOS) trial.
Methods: The baseline and follow-up angiograms of the 80 patients participating in the SOS trial were analyzed to determine the prevalence of intermediate (30-60% angiographic diameter stenosis) SVG lesions and their progression rate.
Results: At least one intermediate SVG lesion was present in 31 of 143 (22%) SVGs in 27 of 80 (34%) patients. Patients with intermediate SVG lesions were older and more likely to present with myocardial infarction. Most intermediate lesions were present in the vein grafts the required stents (20 grafts in 19 patients). During a median follow-up of 35 months, angiographic follow-up was available for 28 grafts in 25 patients. Progression (defined as percent diameter stenosis ≥70% but <100% at follow-up angiography) was seen in 11 of 28 SVGs (39%) in 11 of 25 patients (44%). The rate of progression of the intermediate lesion at 12, 24 and 36 months was 28% and 47% and 84%, respectively (Figure). Seven of 11 patients (64%) whose intermediate SVG lesion progressed presented with an acute coronary syndrome, and 8 (73%) underwent a percutaneous coronary intervention. Four of the 28 grafts with intermediate lesions at baseline were occluded at follow-up; all of those SVGs had received a stent as part of the SOS trial.
Conclusions: Among patients undergoing SVG lesion stenting, intermediate SVG lesions are common, have high rates of progression, and frequently present as an acute coronary syndrome.
- © 2011 by American Heart Association, Inc.