Comparison of long term follow up results of bare metal stent and drug eluting stent on saphenous graft disease

İntroduction: By using invasive methods in coronary artery disease treatment succes has improved greatly. Coronary artery bypass surgery has excellent results in the treatment of stable CAD. But 10 year follow up after CABG has shown that only 50-60% of the vein grafts are not affected by atherosclerotic disease. The atherosclerotic proces of the saphenous veins are characterised with many bad prognostic factors compared with coronary arteries. Because of Redo surgery has much more operative mortality compared with first time CABG, revascularization treatment with percutaneous coronary procedure has started to be an alternative to redo surgery. By using bare metal stents (BMS) on obstructed SVG, complications due to procedure and long term MACE rates have significantly decreased. At percutaneous coronary procedures, drug eluting stents (DES) are superior to BMS on native coronary arteries on minimilazing MACE rates. Although, this results of studies which compares usage of DES with BMS at SVG disease are different. This may be caused that most of these studies are non-randomized and small populated.Aim: We tried to investigate the differences on MACE rates, the charecteristics on patients and procedure and especially the effects of tirofiban and distal emboli protection device on MACE between the two stents after SVG disease.Material and Methods: Between january 2000 and december 2008, 435 patients that underwent percutaneous coronary procedure because of SVG disease is evaluated. The design of the study is retrospective. Patient are divided into two groups as BMS implanted and DES implanted. According to introduction criterias 285 patients, whose ages were between 36-90 (median age 63,38 ? 9,49) were accepted to the study of whom 203 patients used BMS and 83 patients used DES. The avarage follow up is 1-126 months and median follow up is 45,27 ? 31,02 months.Result: There were no statistical significance between patient characteristics. Of these cases 53,3%(n=152) had MACE, 13,3%(n=38) MI, 10,3%(n=29) all cause death, 25,6%(n=73) TVR/TLR, 14,7%(n=42) TVF. There were no statistical difference on tirofiban usage between MACE events but MACE rates were significantly higher between tirofiban users (p>0.05). There were no statistical difference between DES and BMS usage and MACE events(p<0.01), MACE events are 3.03 times more less between DES users(Odds Ratio:3,03; 95% CI:1,77-5,18).Conclusion: Between the two groups, MACE rates are 3 times more less between DES users compared to BMS users. While there were no statistical difference on usage of tirofiban and distal emboli protection device, the MACE rates were higher between tirofiban users.