Paclitaxel-eluting stents reduce neointimal hyperplasia compared to bare metal stents in saphenous vein grafts: Intravascular ultrasonography analysis of the SOS (Stenting Of Saphenous Vein Grafts) trial

O M. Jeroudi
A R R Abdel-Karim
T T. Michael
C Lichtenwalter
J A. De Lemos
O Obel
T Addo
M Roesle
D Haagen
B V. Rangan
D Raghunathan
M DaSilva
B Saeed
J K. Bissett
R Sachdeva
V V. Voudris
P Karyofillis
B Kar
P Berger, Zucker School of Medicine at Hofstra/Northwell
E S. Brilakis

Abstract

Aims: To compare the intravascular ultrasonography (IVUS) findings between saphenous vein grafts (SVG) treated with paclitaxel-eluting stents (PES) vs. bare metal stents (BMS) in the Stenting Of Saphenous Vein Grafts (SOS) trial.Methods and results: Of the 80 SOS trial patients, 38 had both baseline and follow-up IVUS examination and were included in this substudy: 17 patients received 28 BMS in 26 lesions and 21 patients received 30 PES in 28 lesions. Quantitative IVUS analysis was performed to determine the volume of in-stent neointimal hyperplasia (NIH) - defined as the difference between stent volume and lumen volume in the stented segments. Baseline characteristics were similar between patients who did and did not undergo baseline and follow-up IVUS. Patients receiving BMS and PES had similar stent and lumen volumes immediately after stenting. At 12-month follow-up, compared to BMS, PES-treated lesions had significantly less NIH volume (3.4 vs. 21.9 mm3, p<0.001) and neointima hyperplasia progression (1.6 vs. 17.1 mm3, p<0.001). No significant differences were seen in the 5 mm segment proximal and distal to the stent.Conclusions: Compared to BMS, use of PES in SVG lesions is associated with significantly lower NIH formation, which may help explain the improved clinical outcomes with PES in these lesions. © Europa Edition 2011. All rights reserved.