Angiographic patterns of restenosis after sirolimus-eluting stent implantation.
BACKGROUND
Large-scale randomized trials demonstrate a high proportion of focal restenosis after drug-eluting stent (DES) implantation. On the other hand, recent reports have shown that in real-world practice a significant proportion of the restenosis is non-focal when DESs are used in unselected lesions. The present study evaluated angiographic patterns of restenosis after sirolimus-eluting stent (SES) implantation in Japan.


RESULTS
Angiographic restenosis patterns of all consecutive restenotic lesions (n=124) after SES implantation were evaluated and classified according to the following scheme: focal (<or=10 mm in length), diffuse (restenosis >10 mm within the stent), proliferative (restenosis >10 mm in length extending outside the stent), and occlusive. There were 98 focal (79.0%), 15 diffuse (12.1%), and 5 proliferative restenoses (4.0%) and 6 total occlusions (4.8%). Focal intrastent restenosis was most dominant (42.7%). Proximal edge restenosis occurred in 22 lesions (17.7%). Multivariate analysis demonstrated diabetes mellitus (P<0.01) as an independent predictor of non-focal restenosis.


CONCLUSIONS
Focal restenosis is predominant after SES implantation in real-world practice in Japan.
Kitahara
Hideki
H
Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
Kobayashi
Yoshio
Y
Takebayashi
Hideo
H
Nakamura
Yoshitake
Y
Kuroda
Nakabumi
N
Miyazaki
Akira
A
Haruta
Seiichi
S
Komuro
Issei
I
D000368:Aged; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000453:epidemiology; D054855:Drug-Eluting Stents / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D020123:Sirolimus / Q000008:administration & dosage*
D007166:Immunosuppressive Agents; D020123:Sirolimus