title: Clinical and angiographic outcomes after overdilatation of undersized sirolimus-eluting stents with largely oversized balloons: an observational study.
abstract: The purpose of this study was to assess the safety and effectiveness of sirolimus-eluting stent (SES) postdilatation with largely oversized balloons. We evaluated the clinical outcome of 68 consecutive patients enrolled in the Rapamycin-Eluting Stent Evaluated at Rotterdam Cardiology Hospital (RESEARCH) registry who underwent percutaneous coronary intervention with SES implantation and further postdilatation with balloons > 1 mm larger than the stent nominal size. Angiographic follow-up was either scheduled for selected subgroups or clinically driven. Overall, 75 lesions were treated. The procedure was successful in 98.5% of the cases. One patient (1.5%) underwent emergency coronary bypass surgery for acute vessel occlusion. During 10.1 +/- 1.7 months of follow-up, three patients (4.5%) died, one (1.5%) had acute myocardial infarction, and four (6%) had target vessel revascularization. At angiographic follow-up, loss index was 0.13 +/- 0.34 and restenosis rate was 7.7%. Although not routinely recommended in every patient, SES postdilatation with largely oversized balloons appears a safe and effective strategy for selected patients.
authors.affiliation: Erasmus MC, Thoraxcenter, Rotterdam, The Netherlands.
authors.forename: Francesco
authors.initials: F
authors.lastname: Saia
authors.forename: Pedro A
authors.initials: PA
authors.lastname: Lemos
authors.forename: Chourmouzios A
authors.initials: CA
authors.lastname: Arampatzis
authors.forename: Angela
authors.initials: A
authors.lastname: Hoye
authors.forename: Eugene
authors.initials: E
authors.lastname: McFadden
authors.forename: Georgios
authors.initials: G
authors.lastname: Sianos
authors.forename: Pieter C
authors.initials: PC
authors.lastname: Smits
authors.forename: Willem J
authors.initials: WJ
authors.lastname: van der Giessen
authors.forename: Pim J
authors.initials: PJ
authors.lastname: de Feyter
authors.forename: Ron T
authors.initials: RT
authors.lastname: van Domburg
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
mesh_terms: D000368:Aged; D019917:Blood Vessel Prosthesis Implantation; D002404:Catheterization; D020099:Coated Materials, Biocompatible / Q000627:therapeutic use*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis / Q000628:therapy; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000628:therapy; D009426:Netherlands / Q000453:epidemiology; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000627:therapeutic use; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D012086:Reoperation; D020123:Sirolimus / Q000627:therapeutic use*; D015607:Stents; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D020099:Coated Materials, Biocompatible; D007166:Immunosuppressive Agents; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D020123:Sirolimus