| Autor: |
Ekaterina, Iofina, Viktoria, Gorchtein, Peter W, Radke, Daniella, Schubert, Andreas, Franke, Roswitha, Langenberg, Peter, Hanrath, Jürgen, Vom Dahl, Rainer, Hoffmann |
| Rok vydání: |
2009 |
| Zdroj: |
EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. 2(4) |
| ISSN: |
1774-024X |
| Popis: |
Sirolimus-eluting stents (SES) have been shown during short follow-up periods to be effective for treatment of in-stent restenosis (ISR). This study evaluated the 30-months clinical efficacy after SES for treatment of ISR in comparison with intracoronary radiation therapy (IRT).Seventy-two consecutive ISR lesions in native coronary arteries (30 mm lesion length, reference diameter3.5 mm) of 72 patients were treated with SES. SES were used in 16 lesions after failed IRT and in 56 lesions for first time ISR. Seventy-two patients with 72 lesions from a prospective registry of 141 patients treated with IRT (beta-radiation) were matched for diabetes, reference vessel diameter, lesion length, and pattern of ISR to present the control group. At 6-months in-stent late loss was 0.29+/-0.48 vs 0.53+/-0.63 mm for the SES group compared to the IRT group (p=0.025). Target lesion revascularisation (TLR) at 12 month follow-up was performed in 7 lesions (10%) after SES and in 17 lesions (24%) after IRT (P=0.025). TLR rate at 30-months was 13% in the SES group vs 32% in the IRT group (P=0.008). MACE (death, myocardial infarction, target lesion revascularisation) at 30-months was observed in 13 patients (18%) in the SES group and in 25 patients (35%) in the IRT group (P=0.024). Considering only patients treated with SES for first-time ISR, TLR rate was 3.5% at 30-months. In the 16 patients treated with SES after failed IRT TLR rate was 44% at 30-months.Thirty month clinical follow-up of patients treated with SES for first time ISR is favourable compared to follow-up after IRT. However, use of SES after IRT failure is associated with a high rate of recurrent and potentially late treatment failure. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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