Comparison with conventional therapies of repeated sirolimus-eluting stent implantation for the treatment of drug-eluting coronary stent restenosis.
This study compared the safety and efficacy of repeat percutaneous coronary intervention (PCI) using sirolimus-eluting stents (SESs) with conventional therapies for restenosis after drug-eluting stent placement. Fifty-five consecutive patients with 58 restenotic lesions (31 treated with SESs and 27 treated with paclitaxel-eluting stents) underwent PCI using SESs (33 lesions) or conventional therapies comprising cutting balloon angioplasty alone (11 lesions) or intracoronary brachytherapy (14 lesions). Baseline characteristics were similar for the 2 groups, except for greater edge involvement (75.8% vs 36.0%, p = 0.002) and less stent expansion (0.74 +/- 0.17 vs 0.95 +/- 0.21, p = 0.006) in the SES group than in the conventional group. The SES group achieved a greater postprocedural luminal gain than the conventional group (1.98 +/- 0.50 vs 1.22 +/- 0.48 mm, p <0.001). Follow-up angiography showed that late luminal loss (0.27 +/- 0.56 vs 0.76 +/- 0.84 mm, p = 0.021) and recurrent angiographic restenosis rate (3.6% vs 35.0%, p = 0.006) were lower in the SES group than in the conventional group. The repeated target lesion revascularization-free survival rates at 1 year were 96.7 +/- 3.2% for the SES group and 91.7 +/- 5.6% for the conventional group (p = 0.399). In conclusion, use of SESs was associated with a lower recurrent restenosis rate compared with conventional therapies.
Kim
Young-Hak
YH
Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Lee
Bong-Ki
BK
Park
Duk-Woo
DW
Park
Kyoung-Ha
KH
Choi
Bong-Ryong
BR
Lee
Cheol Whan
CW
Hong
Myeong-Ki
MK
Kim
Jae-Joong
JJ
Park
Seong-Wook
SW
Park
Seung-Jung
SJ
D015906:Angioplasty, Balloon, Coronary; D001918:Brachytherapy; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents
D020123:Sirolimus