Document Detail


Incidence of definite stent thrombosis or in-stent restenosis after drug-eluting stent implantation for treatment of coronary in-stent restenosis. From western denmark heart registry.
MedLine Citation:
PMID:  22511512     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: There are limited data on the optimal management of in-stent restenosis after percutaneous coronary intervention (PCI) with bare metal stent (BMS) or drug-eluting stent (DES) implantations. We assessed the clinical presentation, the incidence, and prognosis of definite stent thrombosis or restenosis after DES implantation for treatment of restenosis. METHODS: From January 2002 to June 2005 all consecutive patients with restenosis < 12 months after index PCI with DES or BMS implantation, were identified in the population based Western Denmark Heart Registry. Patients were followed until 24 months after their first restenosis. RESULTS: A total of 589 lesions were treated for clinically driven restenosis with target lesion revascularization (TLR) within 12 months after the index PCI. Among those, 302 lesions were treated with DES (BMS-restenosis n=244 and DES-restenosis n=58). Admission were due to stable angina pectoris (n= 249 (82.4%)), unstable angina pectoris (n= 34 (11.3%)), or non-ST segment elevation myocardial infarction (n= 19 (6.3%)). The clinical indication was not different between patients with BMS restenosis compared to DES restenosis. In the BMS restenosis group, older age, longer lesion, longer stent length, and a higher number of stents used was observed compared to the DES restenosis group. After a first restenosis, clinically driven re-TLR was seen in 26 (8.6%) patients within the following 24 months, stent thrombosis (median duration 155 days, interquartile range (IQR) 9 to 627 days) was seen in 3 lesions (1.0%) and secondary restenosis (median duration 168 days, IQR 88 to 266 days) was seen in 23 (7.6%) [DES restenosis group 6.9% vs. BMS restenosis group 7.8%, p=0.818] lesions. CONCLUSION: The clinical presentation did not differ between BMS or DES and most patients present with stable angina pectoris. Risk of stent thrombosis or restenosis was not increased in patients with DES restenosis compared to patients with BMS restenosis treated with DES. © 2012 Wiley Periodicals, Inc.
Authors:
Jesper Khedri Jensen; Lisette Okkels Jensen; Christian Juhl Terkelsen; Jens Flensted Lassen; Hans Henrik Tilsted; Knud Noerregaard Hansen; Michael Maeng; Leif Thuesen; Per Thayssen
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-18
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  -     ISSN:  1522-726X     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Wiley Periodicals, Inc.
Affiliation:
Department of Cardiology, Odense University Hospital, Odense. jesperkjensen@dadlnet.dk.
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