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SOS: Paclitaxel-eluting stent yielded lower restenosis rates in saphenous vein graft lesions

Issue: February 2009

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A paclitaxel-eluting stent was associated with lower rates of angiographic restenosis compared with a bare metal stent.

Researchers for the Stenting of Saphenous Vein Grafts (SOS) trial enrolled 80 patients with 112 lesions in 88 saphenous vein grafts into the study. Patients were then randomly assigned to receive either a bare metal stent (n=39) or paclitaxel-eluting stent (n=41). The primary endpoint of the study was binary angiographic restenosis at 12-month angiographic follow-up. Sixty-four stents were implanted in the bare metal stent (Express2, Boston Scientific) group and 64 in the paclitaxel-eluting stent (Taxus, Boston Scientific) group.

According to the researchers, angiographic restenosis occurred in 51% of the lesions in the bare metal stent group vs. 9% of the lesions in the paclitaxel-eluting stent group (RR=0.18; 95% CI, 0.07-0.48). Angiographic restenosis occurred in 20 of 33 (61%) patients in the bare metal stent group compared with four of 33 (12%) in the paclitaxel-eluting stent group (RR=0.20; 95% CI, 0.08-0.52). In the saphenous vein grafts, restenosis occurred in 21 of 37 (57%) grafts in the bare metal stent group vs. four of 35 (11%) grafts in the paclitaxel-eluting stent group (RR=0.20; 95% CI, 0.08-0.53). Seven patients died during follow-up, including two (5%) in the bare metal stent group compared with five (12%) in the paclitaxel-eluting stent group (P=.27).

“The use of paclitaxel-eluting stent in saphenous vein graft lesions is associated with lower rates of angiographic restenosis and target vessel failure than bare metal stents,” the researchers wrote. “Large, prospective, multicenter, randomized clinical trials that use a clinical rather than angiographic endpoint are needed to confirm the beneficial role of drug-eluting stents in saphenous vein graft lesions.”

For more information:

• J Am Coll Cardiol. 2009;doi:10.1016/j.jacc.2008.11.029.