Re-restenosis and target lesion revascularization after treatment of sirolimus-eluting stent restenosis: retrospective analysis of 4 Japanese hospitals.
BACKGROUND
There is limited information about optimal management of drug-eluting stent (DES) restenosis. This study evaluated the incidences of re-restenosis and re-target lesion revascularization (TLR) after the treatment of sirolimus-eluting stent (SES) restenosis.


RESULTS
A total of 102 lesions in 101 patients who underwent TLR for SES restenosis were classified according to: (1) focal (lesion length < or = 10 mm) or non-focal restenosis (>10 mm); and (2) use of DES for TLR: (1) focal restenosis treated with DES (focal-DES, n=40); (2) focal restenosis treated by balloon angioplasty (focal-balloon, n=31); (3) non-focal restenosis with DES (non-focal-DES, n=17); and (4) non-focal restenosis by balloon angioplasty (non-focal-balloon, n=14). Re-restenosis and re-TLR were observed in 6 (19.4%) and 5 lesions (12.5%) of the focal-DES group, in 13 (65.0%) and 11 (35.5%) of the focal-balloon group, in 7 (50.0%) and 6 (35.3%) of the non-focal-DES group, and in 8 (61.5%) and 7 (50.0%) of the non-focal-balloon group, respectively (P<0.05 for restenosis and TLR between the focal-DES group and other groups).


CONCLUSIONS
Re-DES implantation for focal DES restenosis results in lower re-restenosis and re-TLR rates compared to re-DES implantation for non-focal DES restenosis or conventional balloon angioplasty either for focal or non-focal DES restenosis.
Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, Japan.
Hideki
H
Kitahara
Yoshio
Y
Kobayashi
Hideo
H
Takebayashi
Yoshihide
Y
Fujimoto
Yoshitake
Y
Nakamura
Nakabumi
N
Kuroda
Toshiharu
T
Himi
Akira
A
Miyazaki
Seiichi
S
Haruta
Issei
I
Komuro
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation*; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D023903:Coronary Restenosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D023921:Coronary Stenosis / Q000453:epidemiology / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D006761:Hospitals; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012189:Retrospective Studies; D018570:Risk Assessment; D020123:Sirolimus / Q000008:administration & dosage*; D016896:Treatment Outcome
D002317:Cardiovascular Agents; D020123:Sirolimus