Stenting for in-stent restenosis: A long-term clinical follow-up.
We studied the feasibility, safety, and short- and long-term outcomes of treating coronary in-stent restenosis with primary restenting. Thirty-one patients (32 lesions) were treated. Eleven patients had adjunctive rotational atherectomy. Clinical follow-up was obtained in all 31 patients at a mean of 9.1 +/- 5.5 months by direct phone contact with the patients, medical records, and subsequent hospitalization for recurrent symptoms and/or revascularization. There were no cardiac deaths or myocardial infarctions. In native vessels (26 patients), repeat target lesion revascularization was required in eight patients (31%); two other patients (7.7%) had angina and were treated medically. All vein graft lesions had recurrent restenosis. Significant predictors of recurrent clinical events were lesions in vein grafts, multivessel disease, and use of higher poststent deployment inflation pressures. Primary restenting for in-stent restenosis in native vessels is a safe approach with good short-term outcome. Recurrent restenosis remains a problem, as it does with other devices, particularly in vein graft lesions and in patients with multivessel disease. Restenting for in-stent restenosis should probably be used selectively. Cathet. Cardiovasc. Intervent. 48:143-148, 1999.
Al-Sergani
H S
HS
Cardiovascular Division of the Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA.
Ho
P C
PC
Nesto
R W
RW
Lewis
S M
SM
Leeman
D
D
Fitzpatrick
P
P
Mittleman
M
M
Waxman
S
S
Shubrooks
S J
SJ
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D017225:Atherectomy, Coronary; D003131:Combined Modality Therapy; D003327:Coronary Disease / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D012008:Recurrence; D019233:Retreatment; D015607:Stents