In-Stent Restenosis in Saphenous Vein Grafts (from the DIVA Trial)

Iosif Xenogiannis, Bavana V. Rangan, Lauren Uyeda, Subhash Banerjee, Robert Edson, Deepak L. Bhatt, Steven Goldman, David R. Holmes, Sunil V. Rao, Kendrick Shunk, Kreton Mavromatis, Kodangudi Ramanathan, Antony A. Bavry, Edward O. McFalls, Santiago Garcia, Hoang Thai, Barry F. Uretsky, Faisal Latif, Ehrin Armstrong, Jose OrtizHani Jneid, Jayson Liu, Kul Aggrawal, Todd A. Conner, Todd Wagner, Judit Karacsonyi, Beverly Ventura, Aaron Alsleben, Ying Lu, Mei Chiung Shih, Emmanouil S. Brilakis

Research output: Contribution to journalArticlepeer-review

Abstract

Saphenous vein grafts (SVGs) have high rates of in-stent restenosis (ISR). We compared the baseline clinical and angiographic characteristics of patients and lesions that did develop ISR with those who did not develop ISR during a median follow-up of 2.7 years in the DIVA study (NCT01121224). We also examined the ISR types using the Mehran classification. ISR developed in 119 out of the 575 DIVA patients (21%), with similar incidence among patients with drug-eluting stents and bare-metal stents (BMS) (21% vs 21%, p = 0.957). Patients in the ISR group were younger (67 ± 7 vs 69 ± 8 years, p = 0.04) and less likely to have heart failure (27% vs 38%, p = 0.03) and SVG lesions with Thrombolysis In Myocardial Infarction 3 flow before the intervention (77% vs 83%, p <0.01), but had a higher number of target SVG lesions (1.33 ± 0.64 vs 1.16 ± 0.42, p <0.01), more stents implanted in the target SVG lesions (1.52 ± 0.80 vs 1.31 ± 0.66, p <0.01), and longer total stent length (31.37 ± 22.11 vs 25.64 ± 17.42 mm, p = 0.01). The incidence of diffuse ISR was similar in patients who received drug-eluting-stents and BMS (57% vs 54%, p = 0.94), but BMS patients were more likely to develop occlusive restenosis (17% vs 33%, p = 0.05).

Original languageEnglish (US)
JournalAmerican Journal of Cardiology
DOIs
StateAccepted/In press - 2021
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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