title: Clinical and angiographic outcome in patients with in-stent restenosis and repeat target lesion revascularisation in small coronary arteries.
abstract: OBJECTIVE
  To evaluate the clinical and angiographic outcome in patients with in-stent restenosis in small coronary arteries and repeat target lesion revascularisation.
  
  
  METHODS
  Patients with in-stent restenosis in coronary arteries < or = 2.85 mm were eligible for the study and underwent target lesion revascularisation. Clinical and angiographic variables were assessed during a six month follow up period.
  
  
  RESULTS
  73 patients with 79 lesions were treated by percutaneous transluminal coronary angioplasty (47%), excimer laser angioplasty (25%), or restenting (28%). The mean (SD) reference diameter before target lesion revascularisation was 2.12 (0.5) mm. Procedural success was achieved in all cases, but 57% of the patients had restenosis after six months. The rate of further restenosis was higher with laser angioplasty (78%) than with restenting (47%) or balloon angioplasty alone (49%, p < 0.05).
  
  
  CONCLUSIONS
  Treatment for in-stent restenosis in small coronary arteries is feasible and safe, with a second restenosis rate comparable to large coronary artery series. The strategy of target lesion revascularisation influences further in-stent restenosis, with an increased rate with laser angioplasty compared with restenting and repeat dilatation alone.
authors.affiliation: Franz Volhard Clinic at the Max Delbrück Centre, Charité, Campus Berlin-Buch, Humboldt University, Berlin, Germany. Gross@fvk-berlin.de
authors.forename: C M
authors.initials: CM
authors.lastname: Gross
authors.forename: J
authors.initials: J
authors.lastname: Krämer
authors.forename: O
authors.initials: O
authors.lastname: Weingärtner
authors.forename: F
authors.initials: F
authors.lastname: Uhlich
authors.forename: R
authors.initials: R
authors.lastname: Dietz
authors.forename: J
authors.initials: J
authors.lastname: Waigand
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D015906:Angioplasty, Balloon, Coronary; D017222:Angioplasty, Balloon, Laser-Assisted; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation; D015607:Stents