In-stent restenosis after interventional treatment of carotid artery stenoses: a long-term follow-up of a single center cohort.

Autor: Kammler J; Faculty of Medicine, Department of Cardiology, Med Campus III, Kepler University Hospital Linz, Krankenhausstrasse 9, 4021, Linz, Austria. juergen.kammler@kepleruniklinikum.at., Blessberger H; Faculty of Medicine, Department of Cardiology, Med Campus III, Kepler University Hospital Linz, Krankenhausstrasse 9, 4021, Linz, Austria., Lambert T; Faculty of Medicine, Department of Cardiology, Med Campus III, Kepler University Hospital Linz, Krankenhausstrasse 9, 4021, Linz, Austria., Kellermair J; Faculty of Medicine, Department of Cardiology, Med Campus III, Kepler University Hospital Linz, Krankenhausstrasse 9, 4021, Linz, Austria., Grund M; Faculty of Medicine, Department of Cardiology, Med Campus III, Kepler University Hospital Linz, Krankenhausstrasse 9, 4021, Linz, Austria., Nahler A; Faculty of Medicine, Department of Cardiology, Med Campus III, Kepler University Hospital Linz, Krankenhausstrasse 9, 4021, Linz, Austria., Lichtenauer M; Department of Internal Medicine II, Paracelsus Medical University Salzburg, Salzburg, Austria., Schwarz S; Faculty of Medicine, Department of Cardiology, Med Campus III, Kepler University Hospital Linz, Krankenhausstrasse 9, 4021, Linz, Austria., Reiter C; Faculty of Medicine, Department of Cardiology, Med Campus III, Kepler University Hospital Linz, Krankenhausstrasse 9, 4021, Linz, Austria., Steinwender C; Faculty of Medicine, Department of Cardiology, Med Campus III, Kepler University Hospital Linz, Krankenhausstrasse 9, 4021, Linz, Austria.; Department of Internal Medicine II, Paracelsus Medical University Salzburg, Salzburg, Austria., Kypta A; Faculty of Medicine, Department of Cardiology, Med Campus III, Kepler University Hospital Linz, Krankenhausstrasse 9, 4021, Linz, Austria.
Jazyk: angličtina
Zdroj: Clinical research in cardiology : official journal of the German Cardiac Society [Clin Res Cardiol] 2017 Jul; Vol. 106 (7), pp. 493-500. Date of Electronic Publication: 2017 Feb 08.
DOI: 10.1007/s00392-017-1078-1
Abstrakt: Background: Whereas in-stent restenosis (ISR) is widely discussed after coronary stenting procedures, this phenomenon is a considerable problem after interventional treatment of carotid artery stenosis as well. We sought to quantify ISR rate and to identify important respective risk factors in our cohort.
Methods: We retrospectively analyzed data of our carotid artery stenting database comprising 1165 angiographically successful interventional procedures during the last 19 years. Significant ISR was assessed by Doppler ultrasound and defined as a flow velocity exceeding 300 cm/s representing a lumen narrowing >70%. Examinations were performed the day after intervention, at follow-up visits 1, 6 and 12 months after index hospitalization and once a year afterwards.
Results: Thirty-nine patients (3.4%) developed a significant ISR > 70% during the follow-up period (median 19.6 months, IQR 5.1-49.6 months). In 13 of them, restenosis was caused by a mechanical collapse (stent crush) of the implanted stent. All patients with significant ISR were free of neurological events during follow-up and 31 patients underwent a stent-in-stent implantation. We found a shorter stent length, a narrower stent diameter, performance of post-dilatation as well as stent type to significantly influence development of ISR.
Conclusion: ISR > 70% after carotid artery stenting is a rare finding also during long-term follow-up. Especially in patients treated with balloon-expandable stents, post-dilatation reduced ISR significantly. As ISR was rare and clinically benign, this technique seems to remain a good therapy option in patients with significant carotid artery stenosis.
Databáze: MEDLINE
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