Key result
Total occlusion at 6 months occurred in 1.6% of stented coronary lesions, independently predicted by stenting for restenotic lesions (P=0.004), longer stent length, and smaller preprocedure MLD.
Why the study?
What are the incidence and predictors of late total occlusion following coronary stenting?
Observational (n=955)
What are the incidence and predictors of late total occlusion following coronary stenting?
Late total occlusion after coronary stenting is rare (1.6%) and is independently predicted by stenting for restenotic lesions, longer stent length, and smaller preprocedure minimum lumen diameter.
Answers are grounded in this paper and cite their sources.
Supports targeted surveillance for high-risk lesions; leaves open whether modifying predictors reduces late occlusion rates.
To determine the incidence and predictors of total occlusion in-stent restenosis, we reviewed three randomized stent vs. stent trials and one stent registry, which provided 955 coronary artery lesions with 6-month angiographic follow-up. Fifteen (1.6%) of the 955 stented lesions were totally occluded at 6-month follow-up. Most patients with total occlusion presented with recurrent angina at the time of repeat angiography (60.0%) while no patient presented with an acute ST segment elevation myocardial infarction. The univariate predictors of total occlusion following elective coronary stenting included stenting for restenosis after a previous percutaneous intervention (P = 0.001), longer stent length (P < 0.001), longer lesion length (P < 0.001), smaller reference vessel diameter (P = 0.022), smaller preprocedure minimum lumen diameter (MLD; P = 0.004), and smaller postprocedure MLD (P = 0.036). Stepwise multiple logistic regression analysis demonstrated that stenting for restenotic lesions (P = 0.004), longer stent length (P < 0.001), and smaller preprocedure MLD (P = 0.012) were independent predictors of total occlusion following coronary stenting.
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Shah et al. (2003) conducted an observational in Coronary artery lesions requiring stenting (n=955). Coronary stenting was evaluated on Total occlusion in-stent restenosis. Total occlusion at 6 months occurred in 1.6% of stented coronary lesions, independently predicted by stenting for restenotic lesions (P=0.004), longer stent length, and smaller preprocedure MLD.
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