Balloon angioplasty for treatment of in-stent restenosis: feasibility, safety, and efficacy.
Sixty patients with 1 or 2 stainless steel intracoronary stents (Cook, Inc.) underwent balloon angioplasty for in-stent restenosis 1.5-13.5 months after stenting. Seventy-five in-stent redilatation procedures were performed. Seventy-three restenotic lesions (97%) were successfully recrossed and dilated, reducing the mean pre-angioplasty intrastent diameter stenosis from 77 +/- 12% to 20 +/- 11% residual. Although one angioplasty (1.3%) was complicated by non-Q-wave infarction, no angioplasty-related death, acute closure, need for additional stenting, emergent coronary bypass surgery, side branch occlusion, or vascular sequelae occurred. Post-procedure heparin was not used in 83% of successful cases. Most patients were discharged the day following redilatation (mean in-hospital stay 1.7 +/- 1.3 days). At 5.4 +/- 3.4 months following in-stent angioplasty, 84% of patients were in Canadian Cardiovascular Society class 0 or I. In conclusion, balloon dilatation in this stent for restenosis appears simple and efficacious in the short term, and may entail less risk than dilatation of unprotected coronary vessels.
Macander
P J
PJ
Department of Medicine, University of Alabama at Birmingham.
Roubin
G S
GS
Agrawal
S K
SK
Cannon
A D
AD
Dean
L S
LS
Baxley
W A
WA
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003327:Coronary Disease / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents / Q000009:adverse effects