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Percutaneous coronary intervention for the treatment of saphenous vein grafts

Friday, 17 September, 2010 - 17:30
Campus: Brussels Health Campus
Faculty: Medicine and Pharmacy
auditorium P. Brouwer
Paul Vermeersch
phd defence

In the beginning of this millennium , the adjunct
of drugs directly onto metallic stents made that
stents were not only used to scaffold the vessel,
but also to elute drugs with the potential to
inhibit the processes leading to restenosis . A
restenosis rate of less than 10% was achieved,
however some concerns related to the safety,
possibly linked to the higher stent thrombosis
rate , were raised.

We focused on the use of drug eluting stents for
the treatment of diseased saphenous vein grafts,
usually excluded from the randomized trials.
The purpose of this research was to assess acute
and long term efficacy and safety of drug-eluting
stents.

Saphenous vein grafts have always been,
considered high risk, both for their inherent risks
of acute embolization resulting in distal
myocardial damage and for increased restenosis,
higher than in native coronary arteries. We
conducted the first randomized trial comparing
bare metal stents and sirolimus eluting stents in
saphenous vein grafts. The results of this trial
showed a significant reduction of restenosis at 6
months, however, on the long term increased
major cardiac event rates were more prevalent in
the drug eluting stent group.