1. Introduction
Stenosis, restenosis
STENOSIS, DEGENERATED, CORONARY ARTERY DISEASES, STENOSES, RESTENOSIS
Coronary artery bypass graft (CABG) surgery, whilst declining, is still a frequent procedure used worldwide for the treatment of coronary artery diseases. Although guidelines recommend a full arterial revascularization, most patients still receive at least one or more saphenous vein grafts in daily routine practice [Another important aspect is the difficulty in selecting the adequate coronary device. Until now, it is still unclear whether drug-eluting stents (DES), which proved superior compared to bare metal stents (BMS) for native coronary interventions, have the same advantages in the treatment of SVG stenoses. Although DES performed better compared to BMS in the ISAR-CABG trial at one-year follow-up, after a longer period of observation (5 years), MACE rates in both groups did not differ anymore [Self-expanding drug-eluting stents (SExS) may have some advantages over conventional balloon expandable drug-eluting stents (BExS) due to their unique design (tight stent struts, active outward force, soft expansion, full stent apposition) [A single center observation of 42 patients treated with SExS in degenerated SVG stenoses demonstrated a low restenosis rate of 4.8% after a median follow up of 13.4 months, proving the feasibility of SExS use in daily routine practice, however no peer group was evaluated [Therefore, the Memmingen Coronary Artery bypass Stenosis Trial (MECAST) was initiated to analyze the potential clinical benefit of SExS in comparison to BExS regarding patient outcome for intervention of degenerated SVGs in daily routine practice.