The DOI matches its Crossref record; 10 of the 10 references it cites were found in a registry or an index.
Stent Placement Compared with Balloon Angioplasty for Obstructed Coronary Bypass Grafts
Open accessAbstract
BACKGROUND: Treatment of stenosis in saphenous-vein grafts after coronary-artery bypass surgery is a difficult challenge. The purpose of this study was to compare the effects of stent placement with those of balloon angioplasty on clinical and angiographic outcomes in patients with obstructive disease of saphenous-vein grafts. METHODS: A total of 220 patients with new lesions in aortocoronary-venous bypass grafts were randomly assigned to placement of Palmaz-Schatz stents or standard balloon angioplasty. Coronary angiography was performed during the index procedure and six months later. RESULTS: As compared with the patients assigned to angioplasty, those assigned to stenting had a higher rate of procedural efficacy, defined as a reduction in stenosis to less than 50 percent of the vessel diameter without a major cardiac complication (92 percent vs. 69 percent, P<0.001), but they had more frequent hemorrhagic complications (17 percent vs. 5 percent, P<0.01). Patients in the stent group had a larger mean (+/-SD) increase in luminal diameter immediately after the procedure (1.92+/-0.30 mm, as compared with 1.21+/-0.37 mm in the angioplasty group; P<0.001) and a greater mean net gain in luminal diameter at six months (0.85+/-0.96 vs. 0.54+/-0.91 mm, P=0.002). Restenosis occurred in 37 percent of the patients in the stent group and in 46 percent of the patients in the angioplasty group (P=0.24). The outcome in terms of freedom from death, myocardial infarction, repeated bypass surgery, or revascularization of the target lesion was significantly better in the stent group (73 percent vs. 58 percent, P = 0.03). CONCLUSIONS: As compared with balloon angioplasty, stenting of selected venous bypass-graft lesions resulted in superior procedural outcomes, a larger gain in luminal diameter, and a reduction in major cardiac events. However, there was no significant benefit in the rate of angiographic restenosis, which was the primary end point of the study.
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Cites
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Intracoronary Stenting Without Anticoagulation Accomplished With Intravascular Ultrasound Guidance
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Coronary bypass graft fate: Long-term angiographic study
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Cited by
What is meant by intention to treat analysis? Survey of published randomised controlled trials
Hollis, S., & Campbell, F. (1999) · BMJ · doi:10.1136/bmj.319.7211.670 · Cited by 2,160
Scanlon, P. J., Faxon, D. P., Audet, A.-M., Carabello, B., Dehmer, G. J., Eagle, K. A., Legako, R. D., Leon, D. F., Murray, J. A., Nissen, S. E., et al. (1999) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(99)00126-6 · Cited by 1,123
Self-citationStent Thrombosis in the Modern Era: A Pooled Analysis of Multicenter Coronary Stent Clinical Trials
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Metadata
- Authors
- Savage, M. P., Douglas, J. S., Fischman, D. L., Pepine, C. J., King, S. B., Werner, J. A., Bailey, S. R., Overlie, P. A., Fenton, S. H., Brinker, J. A., Leon, M. B., Goldberg, S., Heuser, R., Smalling, R., Safian, R. D., Cleman, M., Buchbinder, M., Snead, D., Rake, R. C., & Gebhardt, S.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1997-09-11
- Volume
- 337
- Issue
- 11
- Pages
- 740-747
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2329072970
- Cited by
- 486
- References
- 10
- FWCI
- 44.05
- Type
- journal article
- Language
- en
- Open access
- green
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- Savage, M. P., Douglas, J. S., Fischman, D. L., Pepine, C. J., King, S. B., Werner, J. A., Bailey, S. R., Overlie, P. A., Fenton, S. H., Brinker, J. A., Leon, M. B., Goldberg, S., Heuser, R., Smalling, R., Safian, R. D., Cleman, M., Buchbinder, M., Snead, D., Rake, R. C., & Gebhardt, S. (1997). Stent Placement Compared with Balloon Angioplasty for Obstructed Coronary Bypass Grafts. New England Journal of Medicine. https://doi.org/10.1056/nejm199709113371103
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
