title: Same or Different Drug-Eluting Stent Re-Implantation for Drug-Eluting Stent Restenosis: An Assessment Including Second-Generation Drug-Eluting Stents.
abstract: OBJECTIVE
  We examined the long-term outcomes of implanting a different type of drug-eluting stent (DES), including second-generation DES, for treatment of DES-in stent restenosis (ISR).
  
  
  BACKGROUND
  Treatment for DES-ISR has not been standardized.
  
  
  METHODS
  The subjects were 80 patients with 89 lesions underwent DES implantation for DES-ISR. The patients were divided into the group of patients receiving the same DES for DES-ISR (Homo-stent: 24 patients, 25 lesions) and a different DES for DES-ISR (Hetero-stent: 56 patients, 64 lesions). The primary endpoint was survival free of major adverse cardiovascular events (MACE), including cardiac death, myocardial infarction, and target vessel revascularization (TVR). The secondary endpoint was late loss at 8-12 months follow-up. In the subgroup of patients who were treated with second-generation DES for DES-ISR, we also assessed the survival free of MACE.
  
  
  RESULTS
  During a mean follow-up of 45.1 ± 21.2 months, 26 patients experienced MACE. There was no significant difference in the survival free of MACE (Log rank P = 0.17). In the sub-analysis of second generation DES, MACE was significantly higher in the Homo-stent group compared to the Hetero-stent group (Log rank P = 0.04). Late loss was significantly higher in the Homo-stent group than in the Hetero-stent group (0.86 ± 1.03 vs. 0.38 ± 0.74 mm, P = 0.03). This trend was prominent in the first-generation DES group.
  
  
  CONCLUSIONS
  Although there was no significant difference in MACE between the Hetero-stent and the Homo-stent groups including both first and second-generation DES, the sub-analysis demonstrated different DES implantation for DES-ISR significantly improved the MACE rate among patients treated with second-generation DES. (J Interven Cardiol 2016;29:311-318).
authors.affiliation: Department of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Yabe
authors.affiliation: Department of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, Japan.
authors.forename: Mikihito
authors.initials: M
authors.lastname: Toda
authors.affiliation: Department of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, Japan.
authors.forename: Rine
authors.initials: R
authors.lastname: Nakanishi
authors.affiliation: Department of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, Japan.
authors.forename: Daiga
authors.initials: D
authors.lastname: Saito
authors.affiliation: Department of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, Japan.
authors.forename: Ippei
authors.initials: I
authors.lastname: Watanabe
authors.affiliation: Department of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, Japan.
authors.forename: Ryo
authors.initials: R
authors.lastname: Okubo
authors.affiliation: Department of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Amano
authors.affiliation: Department of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, Japan.
authors.forename: Takanori
authors.initials: T
authors.lastname: Ikeda
mesh_terms: D000368:Aged; D017023:Coronary Angiography / Q000379:methods; D023903:Coronary Restenosis / Q000601:surgery*; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome