Restenosis after coronary placement of various stent types
| Autor: | Claus Schmitt, Adnan Kastrati, Melchior Seyfarth, Kurt Ulm, Josef Dirschinger, Franz-Josef Neumann, Albert Schömig, Rudolf Blasini, Jürgen Pache, Julinda Mehilli, Helmut Schühlen |
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| Rok vydání: | 2001 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Coronary Disease Coronary Angiography Lesion Restenosis Recurrence Risk Factors Internal medicine Coronary stent medicine Humans Risk factor Analysis of Variance medicine.diagnostic_test business.industry Incidence (epidemiology) Stent Equipment Design Middle Aged equipment and supplies medicine.disease Surgery Multivariate Analysis Angiography Unselected population Cardiology Female Stents Radiology medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | The American Journal of Cardiology. 87:34-39 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/s0002-9149(00)01268-6 |
| Popis: | Coronary stent implantation is being performed in an increasing number of patients with a wide spectrum of clinical and lesion characteristics. A variety of stent designs are now available and continuous efforts are being made to improve the stent placement procedure. The objective of this study was to perform a comprehensive analysis of the relation between clinical, lesion, and procedural factors, and restenosis after intracoronary stenting in a large and unselected population of patients. A consecutive series of 4,510 patients with coronary stent placement was analyzed. Exclusion criteria were only a failed procedure and an adverse outcome within the first month after the intervention. Follow-up angiography was performed in 80% of patients at 6 months. Clinical, lesion, and procedural data from all 3,370 patients (4,229 stented lesions) with follow-up angiography were analyzed in a logistic regression model for restenosis (or =50% diameter stenosis). Clinical factors contributed to the predictive power of the model much less than lesion and procedural factors. The strongest risk factor for restenosis was a small vessel size, with a 79% increase in the risk for a vessel of 2.7 mm versus a vessel of 3.4 mm in diameter. Stent design was the second strongest factor; the incidence of restenosis ranged from 20.0% to 50.3% depending on the stent type implanted. In conclusion, this study demonstrates the predominant role of lesion and procedural factors in determining the occurrence of restenosis after coronary stent placement. Among these factors, stent design appears to play a particularly important role in the hyperplastic response of the vessel wall. |
| Databáze: | OpenAIRE |
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