Membrane-covered stents: A new treatment strategy for saphenous vein graft lesions

TY - JOUR

T1 - Membrane-covered stents: A new treatment strategy for saphenous vein graft lesions

AU - Baldus, Stephan

AU - Kster, Ralf

AU - Reimers, Jacobus

AU - Khler, Jan

AU - Meinertz, Thomas

AU - Hamm, Christian W.

PY - 2001

Y1 - 2001

N2 - The restenosis rate after stenting of lesions in aortocoronary venous bypass grafts still has to be considered unsatisfactorily high. We investigated a new stent design characterized by an expandable polytetrafluorethylene (PTFE) membrane in between two layers of struts. Five consecutive male patients (age 70 ± 6 years) were followed prospectively who presented with at least two de novo lesions in different grafts 13 ± 3 years after bypass surgery. A total of 11 lesions were treated located in grafts anastomosed to the circumflex (n = 3), to the LAD (n = 7), and to the right coronary artery (n = 1). Within the same procedure, every patient received membrane-covered stents (n = 6) and conventional stents (n = 5) in either of their lesions. All patients underwent successful interventions. The minimal luminal diameter increased from 1.0 ± 0.5 to 2.9 ± 0.6 mm in lesions treated by the membrane-covered stents and from 0.8 ± 0.4 to 2.4 ± 0.7 mm in the lesions treated by conventional stents. During follow-up, four out of five patients required angioplasty for in-stent restenosis of lesions covered by a conventional stent, whereas no patient underwent revascularization for a lesion treated by a membrane-covered device. The mean minimal luminal diameter of lesions covered by a conventional stent decreased by 42% to 1.4 ± 0.6 mm; the mean minimal luminal diameter of the lesions treated by a stent graft declined by 9% to 2.8 ± 0.6 mm (P < 0.05). This series of intraindividual comparisons suggests that membrane-covered stents may have the power to reduce in-stent restenosis in obstructed aortocoronary venous bypass grafts.

AB - The restenosis rate after stenting of lesions in aortocoronary venous bypass grafts still has to be considered unsatisfactorily high. We investigated a new stent design characterized by an expandable polytetrafluorethylene (PTFE) membrane in between two layers of struts. Five consecutive male patients (age 70 ± 6 years) were followed prospectively who presented with at least two de novo lesions in different grafts 13 ± 3 years after bypass surgery. A total of 11 lesions were treated located in grafts anastomosed to the circumflex (n = 3), to the LAD (n = 7), and to the right coronary artery (n = 1). Within the same procedure, every patient received membrane-covered stents (n = 6) and conventional stents (n = 5) in either of their lesions. All patients underwent successful interventions. The minimal luminal diameter increased from 1.0 ± 0.5 to 2.9 ± 0.6 mm in lesions treated by the membrane-covered stents and from 0.8 ± 0.4 to 2.4 ± 0.7 mm in the lesions treated by conventional stents. During follow-up, four out of five patients required angioplasty for in-stent restenosis of lesions covered by a conventional stent, whereas no patient underwent revascularization for a lesion treated by a membrane-covered device. The mean minimal luminal diameter of lesions covered by a conventional stent decreased by 42% to 1.4 ± 0.6 mm; the mean minimal luminal diameter of the lesions treated by a stent graft declined by 9% to 2.8 ± 0.6 mm (P < 0.05). This series of intraindividual comparisons suggests that membrane-covered stents may have the power to reduce in-stent restenosis in obstructed aortocoronary venous bypass grafts.

KW - Coronary in-stent restenosis

KW - Polytetrafluorethylene

KW - Venous bypass graft

UR - http://www.scopus.com/inward/record.url?scp=0035041121&partnerID=8YFLogxK

U2 - 10.1002/ccd.1119

DO - 10.1002/ccd.1119

M3 - SCORING: Journal article

C2 - 11329208

AN - SCOPUS:0035041121

VL - 53

SP - 1

EP - 4

JO - CATHETER CARDIO INTE

JF - CATHETER CARDIO INTE

SN - 1522-1946

IS - 1

ER -