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Impact of new generation stents in the treatment of aortocoronary venous grafts - angiographic and ultra-sonographic comparison of two first-in-human series: MGuardTM vs. SESAME TM

BACKGROUND: Percutaneous interventions in saphenous vein grafts (SVG) result in lower rates of angiographic success and higher risk of complications, due to the increased risk of embolization of debris from the friable atherosclerotic plaque. With the advent of distal protection devices, improvements in efficacy and safety were achieved in the procedure. Our objective was to compare the MGuardTM and SESAME TM stents, dedicated for SVG treatment, during the first 30 days of follow up. METHODS: This is a retrospective study comparing angiographic and ultra-sonographic variables and clinical events within 30 days in patients with SVG lesions treated with MGuardTM balloon-expandable stents (n = 11) vs. SESAME TM self-expandable stents (n = 14). RESULTS: Patients treated with MGuardTM and SESAME TM stents had similar clinical profiles (mean age 69 years; male gender, 72%; diabetic, 28%; treated for acute coronary syndrome, 44%), equivalent age of aortocoronary venous grafts (9.7 ± 6.2 years vs. 10.1 ± 3.2 years; p = 0.80) and SGV with the same degree of atherosclerotic impairment. Post-procedure angiographic success was reached in all cases, however with a tendency towards better stent expansion in the MGuardTM group (87% vs. 68%; p = 0.08). Over the 30-day clinical follow-up, patients treated with the SESAME TM stent had higher frequency of major cardiac events (two cases of non-Q myocardial infarction and one case of revascularization of the target vessel), compared with no events in the MGuardTM group. CONCLUSIONS: In this retrospective analysis of a small series of pre-selected patients from two first-in-human series, the MGuardTM balloon-expandable stent showed to be superior to the SESAME TM self-expandable stent over the first 30 days of clinical follow-up.

Stents; Angioplasty, transluminal, percutaneous coronary; Coronary artery bypass; Saphenous vein


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