Predictive Factors of Re-restenosis after Repeated Sirolimus-Eluting Stent Implantation for SES Restenosis and Clinical Outcomes after Percutaneous Coronary Intervention for SES Restenosis
| Autor: | Masahiro Yamawaki, Keisuke Hirano, Kenichi Chatani, Motoharu Araki, Hiroshi Ishimori, Yoshiaki Ito, Masayuki Sakurai, Toshiya Muramatsu, Reiko Tsukahara, Hiroshi Inoue, Kazuyuki Iuchi, Masatsugu Nakano, Takashi Nozawa |
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| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Myocardial Infarction Coronary Angiography Coronary Restenosis Restenosis Risk Factors Internal medicine Confidence Intervals Odds Ratio medicine Humans Radiology Nuclear Medicine and imaging cardiovascular diseases Myocardial infarction Angioplasty Balloon Coronary Aged Retrospective Studies Sirolimus business.industry Percutaneous coronary intervention Stent Drug-Eluting Stents Retrospective cohort study social sciences Odds ratio medicine.disease Logistic Models Treatment Outcome Multivariate Analysis Conventional PCI Cardiology population characteristics Female Cardiology and Cardiovascular Medicine business Immunosuppressive Agents Mace |
| Zdroj: | Journal of Interventional Cardiology. 22:354-361 |
| ISSN: | 1540-8183 0896-4327 |
| DOI: | 10.1111/j.1540-8183.2009.00482.x |
| Popis: | Sirolimus-eluting stent (SES) is established to be effective in reducing restenosis. Repeat revascularization, however, is still required in up to 5-8% of patients. In this study, we analyzed clinical and angiographic variables that might be related with SES re-restenosis and variables related with re-restenosis after repeat SES implantation for SES restenosis. We also assessed clinical outcomes at 2-year follow-up after percutaneous coronary intervention (PCI) for SES restenosis. Repeat revascularization for SES restenosis was performed in 113 patients with 140 lesions. Of the 140 lesions, follow-up coronary angiography (CAG) was performed on 117 lesions (101 patients) and revealed 46 SES re-restenotic and 71 non-re-restenotic lesions. In multivariate analysis, SES-in-SES-strategy and reference diameter before the second PCI were independent predictors of re-restenosis after PCI for SES restenosis. However, the reference diameter was the only independent predictor of re-restenosis after SES-in-SES. Major adverse cardiac events (MACE) at 2 years were found in 44 patients (43.5%), and target lesion revascularization (TLR) was performed in 33.7% of patients after SES restenosis. In conclusion, the incidence of MACE and TLR was relatively high in patients with SES restenosis, but the placement of another SES on larger-diameter vessels may be an effective strategy for the second PCI. |
| Databáze: | OpenAIRE |
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