title: Treatment of restenotic drug-eluting stents: an intravascular ultrasound analysis.
abstract: BACKGROUND
  The intravascular ultrasound (IVUS) findings during repeat intervention for drug-eluting stent (DES) restenosis have not been well described.
  
  
  METHODS
  We identified 62 consecutive DES restenosis lesions (45 sirolimus-eluting stents and 17 paclitaxel-eluting stents) undergoing repeat intervention with pre and postintervention IVUS. Lumen, stent and intimal hyperplasia (stent minus lumen) areas were measured at the minimal lumen area (MLA) site and minimal stent area (MSA) site.
  
  
  RESULTS
  Repeat stent implantation was performed in 55 lesions (88.7%). Overall, MLA increased from 2.3 +/- 0.7 mm(2) preintervention to 4.6 +/- 1.6 mm(2) postintervention. Preintervention MLA was seen at exactly the preintervention MSA site in 42%, while 73% of postintervention MLAs were located at the preintervention MSA site. There was a strong correlation between the preintervention MSA and the postintervention MLA (r = 0.79; p < 0.001). Preintervention MSA was the strongest independent predictor of a larger postintervention MLA (coefficient 0.72; p < 0.001).
  
  
  CONCLUSIONS
  The preintervention MSA was a major predictor of larger lumen area after repeat intervention for DES restenosis. Several IVUS studies have shown that stent dimensions do not change over time. Therefore, the MSA of the original stent implantation procedure still has the greatest impact on subsequent interventions to treat DES restenosis.
authors.affiliation: Cardiovascular Research Foundation, 611 Pennsylvania Avenue, S.E., No.386, Washington, D.C., USA.
authors.forename: Koichi
authors.initials: K
authors.lastname: Sano
authors.forename: Gary S
authors.initials: GS
authors.lastname: Mintz
authors.forename: Stephane G
authors.initials: SG
authors.lastname: Carlier
authors.forename: Emilia
authors.initials: E
authors.lastname: Solinas
authors.forename: Jose de Ribamar
authors.initials: Jde R
authors.lastname: Costa
authors.forename: Jie
authors.initials: J
authors.lastname: Qian
authors.forename: Eduardo
authors.initials: E
authors.lastname: Missel
authors.forename: Shoujie
authors.initials: S
authors.lastname: Shan
authors.forename: Theresa
authors.initials: T
authors.lastname: Franklin-Bond
authors.forename: Paul
authors.initials: P
authors.lastname: Boland
authors.forename: Giora
authors.initials: G
authors.lastname: Weisz
authors.forename: Issam
authors.initials: I
authors.lastname: Moussa
authors.forename: George
authors.initials: G
authors.lastname: Dangas
authors.forename: Roxana
authors.initials: R
authors.lastname: Mehran
authors.forename: Alexandra J
authors.initials: AJ
authors.lastname: Lansky
authors.forename: Edward
authors.initials: E
authors.lastname: Kreps
authors.forename: Michael
authors.initials: M
authors.lastname: Collins
authors.forename: Gregg W
authors.initials: GW
authors.lastname: Stone
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Moses
authors.forename: Martin B
authors.initials: MB
authors.lastname: Leon
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging* / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage; D020123:Sirolimus / Q000008:administration & dosage; D018084:Ultrasonography, Interventional
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D007166:Immunosuppressive Agents; D017239:Paclitaxel; D020123:Sirolimus