Vein Grafts

Recurrent restenoses of saphenous vein grafts (SVG) are a common occurrence despite good angiographic results with angioplasty. Stent use was tested in focal SVG lesions in the Saphenous Vein Graft De Novo (SAVED) trial (61) in an attempt to achieve a decreased rate of recurrent restenosis. Patients (220) with new SVG lesions were randomized to PTCA or stent therapy. Stenting not only achieved better initial angiographic results (92 vs 69% angiographic success rate), but also carried an improved rate of freedom from adverse events (73 vs 58%, p = 0.03). Interestingly, there was only a trend towards improvement in restenosis rate associated with stenting vs PTCA (37 vs 46%, p = NS). A separate large, multicenter investigation of 589 patients with SVG lesions experienced a 29.7% restenosis rate at 6 mo, lower than historical controls of PTCA (62).

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