Document Detail

Late target lesion revascularization after implantation of sirolimus-eluting stent.
MedLine Citation:
PMID:  17985380     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: We evaluated the incidence, clinical presentation, and angiographic in-stent restenosis (ISR) pattern of late target lesion revascularization (TLR) after sirolimus-eluting stent (SES) implantation.
BACKGROUND: Late TLR is an unusual finding beyond 6-9 months after bare-metal stent implantation. However, late TLR after SES implantation has not been sufficiently evaluated.
METHODS: The study population consisted of 804 patients with 1,020 native lesions that were patent at 6-month follow-up angiogram after SES implantation.
RESULTS: Late TLR was performed in 18 patients with 18 lesions (1.8%) at 24.1 +/- 2.6 months (range; 18-30 months) after SES implantation. Clinical presentation of late TLR patients was silent ischemia in eight patients and recurrent angina in 10 patients, but none had an acute coronary syndrome. Angiographic ISR pattern of late TLR lesions were focal ISR in 12 lesions (67%) and diffuse ISR in six lesions (33%). Serial quantitative coronary angiographic analysis of these lesions showed a minimal lumen diameter of 2.6 +/- 0.5 mm immediately after SES implantation, 2.4 +/- 0.4 mm at 6-month follow-up and 0.7 +/- 0.6 mm at 24-month follow-up (ANOVA P < 0.001). By stepwise multiple logistic regression analysis, the only independent predictor of late TLR was stent length (P < 0.001, OR = 1.040, 95% CI = 1.019-1.061).
CONCLUSIONS: Late TLR was performed in 1.8% of 1,020 native lesions that were patent at 6-month follow-up angiogram. Clinical presentations of late TLR was either silent ischemia or recurrent angina, but not acute coronary syndrome. Two-thirds of late TLR lesions had a focal angiographic ISR pattern.
Myeong-Ki Hong; Gary S Mintz; Cheol Whan Lee; Duk-Woo Park; Seung-Whan Lee; Young-Hak Kim; In-Hyun Jung; Sang-Hyun Kim; Sang-Sig Cheong; Jae-Joong Kim; Seong-Wook Park; Seung-Jung Park
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  71     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-02-26     Completed Date:  2008-03-27     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  299-303     Citation Subset:  IM    
Copyright Information:
(c) 2007 Wiley-Liss, Inc.
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MeSH Terms
Analysis of Variance
Angioplasty, Balloon, Coronary / adverse effects,  methods*
Cohort Studies
Coronary Angiography
Coronary Restenosis / radiography,  therapy*
Coronary Stenosis / mortality,  radiography,  therapy*
Drug-Eluting Stents / adverse effects*
Follow-Up Studies
Logistic Models
Middle Aged
Prosthesis Failure
Retrospective Studies
Risk Assessment
Severity of Illness Index
Sirolimus / therapeutic use
Statistics, Nonparametric
Survival Rate
Time Factors
Reg. No./Substance:
Comment In:
Catheter Cardiovasc Interv. 2008 Feb 15;71(3):304-5   [PMID:  18288752 ]
Catheter Cardiovasc Interv. 2008 Nov 1;72(5):749   [PMID:  18942148 ]

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