Key result
Treatment of coronary in-stent restenosis with drug-eluting stents resulted in a low 6-month binary restenosis rate of 9.3% and a mean late loss of 0.30 mm.
Why the study?
Do drug-eluting stents improve clinical and angiographic outcomes in patients with coronary in-stent restenosis?
Observational (n=80)
Yes
Do drug-eluting stents improve clinical and angiographic outcomes in patients with coronary in-stent restenosis?
Drug-eluting stents are a safe and effective treatment for coronary in-stent restenosis, demonstrating low rates of recurrent restenosis and major adverse cardiac events at 6 months.
May support DES for in-stent restenosis; leaves open randomized confirmation of efficacy.
Background and Objectives:Treating coronary in-stent restenosis (ISR) has become one of the major challenges for the interventional cardiologist. The aim of this study was to determine the feasibility and safety of treating ISR with drug eluting stents (DESs), and we also wanted to determine the effect of DESs on the prevention of recur- rent restenosis. Subjects and Methods:Eighty patients (age range: 60.9±6.4 year-old, males:females=63:17) with 82 ISR lesions that were treated successfully with DES (sirolimus- and paclitaxel-eluting stents) were enrolled in our study. Five patients received 2 stents for a total mean of 1.1±0.3 stents per lesion. The major adverse car- diac events (MACEs) during hospitalization, at 30 days and at 6 months after the stenting were analyzed along with the coronary angiographic findings. Results:At the time of DES implantation, the mean number of ISRs was 1.4±0.9, and the patterns of ISR according to the Mehran classification were IB in 9 lesions (10.5%), IC in 3 lesions (3.7%), ID in 6 lesions (7.3%), II in 19 lesions (23.2%), III in 30 lesions (36.7%), and IV in 15 le- sions (18.3%). The mean stent length was 27.1±5.6 mm and the mean acute gain was 2.58±0.67 mm. No in- hospital MACE was observed. During the 30-day clinical follow-up, one patient developed acute myocardial in- farction due to a subacute stent thrombosis. Forty two patients with 43 lesions underwent a 6-month follow-up coronary angiogram. The mean late loss at 6 months was 0.30±0.74 mm. The binary restenosis rate was 9.3% (4/43 lesion). The restenosed lesions were treated by balloon angioplasty in three lesions and by additional DES implantation in one lesion. Conclusion:Our results demonstrated that DES was a safe and very effective method for the treatment of ISR. (Korean Circulation J 2005;35:443-447)
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Kim et al. (2005) conducted an observational in Coronary in-stent restenosis (n=80). Drug-eluting stents (sirolimus- and paclitaxel-eluting stents) was evaluated on Binary restenosis rate at 6 months. Treatment of coronary in-stent restenosis with drug-eluting stents resulted in a low 6-month binary restenosis rate of 9.3% and a mean late loss of 0.30 mm.
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