Coronary artery diseaseAngiographic Patterns of Drug-Eluting Stent Restenosis and One-Year Outcomes After Treatment With Repeated Percutaneous Coronary Intervention
Section snippets
Methods
Consecutive patients with DES-ISR who provided signed informed consent at Columbia University Medical Center, New York, New York, from August 2004 to April 2006 were entered in a dedicated database. No other specific exclusion criterion was applied.
The treatment modality of DES-ISR was chosen by individual operators, and all procedures, implantation devices, periprocedural anticoagulation, and antiplatelet therapy were prescribed per standard protocols. Patients were further stratified
Results
During the study period, 137 consecutive patients with 182 lesions underwent percutaneous coronary intervention for DES-ISR, but we excluded from the analysis 12 patients with multiple ISR lesions (total 30) treated with multiple stents. These patients presented a very high-risk profile at baseline, including diabetes (58%), renal insufficiency (25%), and previous coronary artery bypass grafting (58%). The predominant pattern of restenosis in this group of patients was focal (60%), mostly focal
Discussion
The main results of this study are that (1) treatment of DES failure with repeated percutaneous coronary intervention (DES or balloon angioplasty) was safe and effective up to 1 year, and (2) patterns of DES-ISR in our population were predominantly focal, but with a higher proportion of diffuse-intrastent ISR in patients with PES-ISR in comparison to SES-ISR. However, treatment of both types of DES-ISR was associated with good outcomes.
The patterns of angiographic restenosis after bare-metal
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2023, Bioactive MaterialsCitation Excerpt :This condition is characterized by VSMC migration and proliferation, induced mainly by inflammation and ROS production [6,7]. Drug-eluting stents (DESs), embedded in an antiproliferative drug-eluting polymer, were developed to avoid such secondary complications [8,9]. Antiproliferative drugs, such as rapamycin (RAPA) and rapamycin analogs (everolimus, biolimus A9, or zotarolimus), can effectively inhibit early in-stent restenosis by inhibiting the proliferation of VSMCs.
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2014, Journal of the American College of CardiologyCitation Excerpt :The Mehran system permits a morphological classification of BMS-ISR lesions (pattern I, focal; pattern II, diffuse; pattern III, proliferative; and pattern IV, occlusion) and can predict the need for repeat revascularization after intervention (19%, 35%, 50%, and 98%, respectively) (42). This classification scheme also has prognostic value in patients with DES-ISR (43). In addition, the American College of Cardiology/American Heart Association classification has been validated in patients with ISR: B2-C lesions are not only more frequently associated with suboptimal acute results, but also with a higher restenosis rate and poorer long-term clinical outcomes (44).
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