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(Circulation. 2000;102:2024.)
© 2000 American Heart Association, Inc.

Brief Rapid Communications

Treatment of Aortocoronary Vein Graft Lesions With Membrane-Covered Stents

A Multicenter Surveillance Trial

Stephan Baldus, MD; Ralf Köster, MD; Mathias Elsner, MD; Dirk H. Walter, MD; Roman Arnold, MD; Wolfgang Auch-Schwelk, MD; Jürgen Berger, PhD; Mathias Rau, MD; Thomas Meinertz, MD; Andreas M. Zeiher, MD; Christian W. Hamm, MD

From the Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim (S.B., R.A., M.R., C.W.H.); the Department of Cardiology (R.K., T.M.) and Institute of Mathematics and Computer Science in Medicine (J.B.), University Hospital Eppendorf, Hamburg; and the Department of Cardiology, University Hospital Frankfurt (M.E., D.H.W., W.A.-S., A.M.Z.), Germany.

Correspondence to Christian W. Hamm, MD, Kerckhoff Heart Center, Benekestrasse 2-8, 61231 Bad Nauheim, Germany. E-mail christian.hamm{at}kerckoff.med.uni-giessen.de

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.

Key Words: grafting • stents • thrombosis • restenosis • polytetrafluoroethylene

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