Therapeutic Strategy for In-Stent Restenosis Based on the Restenosis Pattern After Drug-Eluting Stent Implantation.
10.4070/kcj.2009.39.10.408
- Author:
Ki Hun KIM
1
;
Doo Il KIM
;
Il Hwan KIM
;
Jong Yoon KIM
;
Yang Chun HAN
;
Sang Hoon SEOL
;
Ung KIM
;
Tae Hyun YANG
;
Dae Kyeong KIM
;
Dong Soo KIM
;
Sang Hee LEE
;
Jong Seon PARK
;
Young Jo KIM
;
Dong Gu SHIN
;
Yoon Kyung CHO
;
Chang Wook NAM
;
Seung Ho HUR
;
Kwon Bae KIM
Author Information
1. Division of Cardiology, Department of Internal Medicine, College of Medicine, Inje University, Busan Paik Hospital, Busan, Korea. jo1216@chollian.net
- Publication Type:Original Article
- Keywords:
Percutaneous transluminal coronary angioplasty;
Restenosis;
Drug-eluting stent;
Coronary restenosis
- MeSH:
Angioplasty, Balloon;
Angioplasty, Balloon, Coronary;
Coronary Restenosis;
Drug-Eluting Stents;
Follow-Up Studies;
Humans;
Percutaneous Coronary Intervention
- From:Korean Circulation Journal
2009;39(10):408-413
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND OBJECTIVES: The aim of this study was to evaluate the outcomes of repeated percutaneous coronary intervention (PCI) based on the restenosis pattern in drug-eluting stent (DES) failure. SUBJECTS AND METHODS: From April 2003 to March 2006, all 67 patients (67 lesions) at our 3 centers who had DES in-stent restenosis (ISR) were enrolled. The patients were divided into 3 groups: group I had focal edge restenosis, group II had focal body restenosis, and group III had non-focal restenosis. All patients were treated with conventional PCI including plain old balloon angioplasty (POBA), cutting balloon angioplasty (CBA), and repeated DES implantation (Re-DES). Angiographic and clinical one year follow-up results for the 3 groups were evaluated. RESULTS: Sixteen patients were enrolled in group I, 36 in group II, and 15 in group III. Baseline clinical and angiographic characteristics and the proportion of patients in each group receiving each type of treatment strategy were not significantly different among the groups. Within each group, a comparison of angiographic and clinical outcomes for each therapeutic modality revealed that restenosis rates were not statistically different. Although rates of major adverse cardiac events (MACE) were not statistically different between groups I and II, in group III, MACE were 3-fold higher for the POBA (4/4, 100.0%) and CBA (4/4, 100.0%) subgroups than for Re-DES (1/3, 33.3%) (p=0.06), but the differences did not reach statistical significance. CONCLUSION: The present study suggests that treatment of DES ISR should be individualized according to restenosis pattern: any PCI strategy appears appropriate for focal ISR patterns, while Re-DES might be a better choice for non-focal ISR patterns.
