Peri-Stent Reference Segment Plaque Burden Is Associated With Disease Progression in Saphenous Vein Grafts (A Serial Intravascular Ultrasound Assessment)

We are aware of no studies of peri-stent disease progression or luminal compromise in saphenous vein graft (SVG) lesions. We used serial intravascular ultrasound (IVUS) to assess disease progression in peri-stent saphenous vein bypass graft reference segments. We studied 37 peri-stent SVG reference segments in 21 patients; 16 were proximal and 21 were distal to the stent. The same anatomic image slice was analyzed after the intervention and at follow-up; this site was 3.68 ± 2.22 mm from the stent edge. Graft age was 10.1 ± 5.4 years, and mean follow-up duration was 13 months (range 3 to 61). Overall, change in SVG area, change in lumen area, and change in plaque burden correlated with postintervention plaque burden (r = 0.448, p = 0.005; r = −0.584, p 50% [n = 20] vs 2 , p 2 , p = 0.027), plaque area (1.37 ± 0.96 vs 0.42 ± 0.30 mm 2 , p 50%. In conclusion, peri-stent reference segment SVG disease progression and lumen loss were more significant in segments with a greater postintervention plaque burden after implantation of a bare metal stent or drug-eluting stent.