Long-term clinical follow-up after successful repeat percutaneous intervention for stent restenosis.
OBJECTIVE
This study evaluated the long-term clinical outcome of successful repeat percutaneous intervention after in-stent restenosis.


BACKGROUND
Recurrence of symptoms and angiographic restenosis after stent implantation are observed in 15% to 35% of cases. Repeat percutaneous treatment for in-stent restenosis has been shown to be safe, with high immediate success, but little is known about the long-term clinical outcome.


METHODS
Clinical follow-up (minimum 9 months) was obtained in a consecutive series of 124 patients (127 vessels) presenting with stent restenosis who were successfully treated with repeat percutaneous intervention.


RESULTS
Clinical follow-up was obtained in all 124 patients at a mean [+/-SD] of 27.4 +/- 14.7 months (range 9 to 66); a stress test was available in 88 patients (71%). Recurrence of clinical events occurred in 25 patients (20%) and included death from any cause in 2 patients (2%), target vessel revascularization in 14 (11%), myocardial infarction in 1 (1%) and positive stress test results or recurrence of symptoms (Canadian Cardiovascular Society class I to IV) treated medically in 8 (6%). Cumulative event-free survival at 12 and 24 months was 86.2% and 80.7%, respectively. Significant predictive factors of recurrence of clinical events were repeat intervention in saphenous vein grafts, multivessel disease, low ejection fraction and a < or = 3-month interval between stent implantation and repeat intervention.


CONCLUSIONS
In-stent balloon angioplasty for stent restenosis in native vessels seems to be an effective method in terms of a low long-term clinical event rate.
Reimers
B
B
Columbus Clinic, Milan, Italy.
Moussa
I
I
Akiyama
T
T
Tucci
G
G
Ferraro
M
M
Martini
G
G
Blengino
S
S
Di Mario
C
C
Colombo
A
A
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D015986:Confounding Factors, Epidemiologic; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D015607:Stents; D016019:Survival Analysis; D016896:Treatment Outcome