title: First clinical experience with a paclitaxel derivate-eluting polymer stent system implantation for in-stent restenosis: immediate and long-term clinical and angiographic outcome.
abstract: BACKGROUND
  It has been shown that antiproliferative drugs such as paclitaxel lower the amount of intimal hyperplasia after stent implantation. We report the first clinical experience of 7-hexanoyltaxol (QP2)-eluting polymer stent system (QuaDS) implantation for in-stent restenosis.
  
  
  RESULTS
  Fifteen consecutive patients with elective indication to percutaneous coronary intervention for in-stent restenosis were treated with the QuaDS-QP2 stent implantation. The QuaDS-QP2 stent was successfully implanted in all but 2 target lesions. In one lesion, the restenotic segment could not be completely covered by the stent, and in another lesion, a bare metal stent was implanted distally to the QuaDS-QP2 stent. One patient suffered from postprocedural non-Q-wave myocardial infarction (NQWMI). No other adverse events were observed during hospital stay. Six- and 12-month angiographic and clinical follow-up was scheduled for all patients. At 6 months, 3 patients had target lesion revascularization (20%). Two patients had restenosis (13.3%); one experienced restenosis in a gap between 2 drug-eluting stents, and the other had stent occlusion leading to NQWMI. Minimal intimal hyperplasia was observed in all the segments covered by drug-eluting stents (late loss=0.47+/-1.01 mm with a loss index=0.17+/-0.39). At 12 months, 1 patient suffered from NQWMI, and 8 of 13 patients (61.5%) had angiographic restenosis (late loss=1.36+/-0.94 mm with a loss index=0.62+/-0.44).
  
  
  CONCLUSIONS
  This first experience with QuaDS-QP2 stent implantation for in-stent restenosis revealed minimal intimal hyperplasia at the 6-month follow-up. However, the antiproliferative effect was not maintained at the 12-month follow-up, resulting in delayed occurrence of angiographic restenosis.
authors: Catheterization Laboratories, Ospedale San Raffaele, and Emo Centro Cuore Columbus, Milan, Italy.
authors: Francesco
authors: F
authors: Liistro
authors: Goran
authors: G
authors: Stankovic
authors: Carlo
authors: C
authors: Di Mario
authors: Takuro
authors: T
authors: Takagi
authors: Alaide
authors: A
authors: Chieffo
authors: Shahram
authors: S
authors: Moshiri
authors: Matteo
authors: M
authors: Montorfano
authors: Mauro
authors: M
authors: Carlino
authors: Carlo
authors: C
authors: Briguori
authors: Paolo
authors: P
authors: Pagnotta
authors: Remo
authors: R
authors: Albiero
authors: Nicola
authors: N
authors: Corvaja
authors: Antonio
authors: A
authors: Colombo
mesh_terms: D001952:Bridged-Ring Compounds / Q000008:administration & dosage / Q000627:therapeutic use*; D017023:Coronary Angiography; D004343:Drug Implants; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D006131:Growth Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D011108:Polymers / Q000008:administration & dosage / Q000627:therapeutic use; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D001952:Bridged-Ring Compounds; D004343:Drug Implants; D006131:Growth Inhibitors; D011108:Polymers; C434083:7-hexanoyltaxol