Outcomes After Implantation of the TAXUS Paclitaxel-Eluting Stent in Saphenous Vein Graft Lesions
| Autor: | Thomas S. Bowman, Emmanouil S. Brilakis, Keith D. Dawkins, Ruth M. Starzyk, David A. Cox, John M. Lasala, Peter B. Berger |
|---|---|
| Rok vydání: | 2010 |
| Předmět: |
medicine.medical_specialty
business.industry Incidence (epidemiology) medicine.medical_treatment Stent Percutaneous coronary intervention medicine.disease Revascularization Surgery law.invention Restenosis Randomized controlled trial law Conventional PCI Occlusion medicine Cardiology and Cardiovascular Medicine business |
| Zdroj: | JACC: Cardiovascular Interventions. 3:742-750 |
| ISSN: | 1936-8798 |
| DOI: | 10.1016/j.jcin.2010.04.012 |
| Popis: | Objectives The aim of this study was to examine the incidence of clinical events after implantation of the TAXUS Express (Boston Scientific Corporation, Natick, Massachusetts) paclitaxel-eluting stent in saphenous vein graft (SVG) lesions in an unselected patient population. Background Saphenous vein grafts have 1-year occlusion rates of 12% to 20%, with >50% failure by 7 to 10 years. Many diseased SVGs are treated by percutaneous coronary intervention to avoid higher-risk reoperation, but bare-metal stents have 35% to 40% historical SVG restenosis rates by 18 months. Reported outcomes of drug-eluting stents in SVG lesions are limited and mainly retrospective. Methods The ARRIVE (TAXUS Peri-Approval Registry: A Multicenter Safety Surveillance) program compiled data on 7,492 patients receiving ≥1 TAXUS Express (Boston Scientific) stent, including 474 patients with SVG. All cardiac events were monitored with independent adjudication of end points. Patients enrolled at procedure start with no mandated inclusion/exclusion criteria. Results The ARRIVE SVG patient 2-year follow-up was 96% complete (457 of 474). The SVG patients had significantly more baseline comorbidities/complex disease than simple-use patients (n = 2,698) undergoing native coronary intervention or other expanded-use patients (n = 4,320 without SVG patients). They had higher 2-year rates of mortality (10.9% vs. 4.2%, p Conclusions The ARRIVE SVG patients have significantly different baseline risk and higher clinical risk through 2 years than simple-use and other expanded-use patients. Nonetheless, compared with historical SVG revascularization rates, treatment with paclitaxel-eluting stent seems to offer a reasonable therapeutic option in this high-risk group. (TAXUS ARRIVE: TAXUS Peri-Approval Registry: A Multicenter Safety Surveillance Program; NCT00569491 ) and (TAXUS ARRIVE 2: A Multicenter Safety Surveillance Program; NCT00569751 ) |
| Databáze: | OpenAIRE |
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