Document Detail

Long-term follow-up of patients with sirolimus-eluting stents for treatment of bare-metal in-stent restenosis.
MedLine Citation:
PMID:  19049847     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Limited data is available on the long-term outcome after sirolimus-eluting stent (SES) implantation for in-stent restenosis. METHODS: In 3 centers, consecutive patients (n=100) with percutaneous coronary intervention (PCI) for in-stent restenosis (n=110) were treated with SES: 28 lesions were focal, 40 diffuse, 17 proliferative, and 15 totally occluded (reference vessel diameter: 3.0+/-0.2 mm, lesion length: 13.8+/-5.7 mm). RESULTS: SES implantation was successful in all patients. The mean follow-up was 50+/-12 months. The main univariate predictive factor of definite (4%) or probable (4%) SES thrombosis was revascularization without SES in a non-target site during the initial procedure (p<0.01). Repeated target lesion revascularization (TLR) was performed in 8 patients (8%) at 1 year, in 10 patients (10%) at 4 years. A cardiac event related to the SES occurred in 14 patients (14%) at one year, 17 patients (17%) at 4 years, and were associated with unstable angina (p<0.05), multivessel disease (p<0.02) and revascularization without SES in another site of the target vessel during the initial procedure (p<0.01). CONCLUSIONS: SESs are effective at 4 years in the treatment of high risk patients with complex in-stent restenosis, with a low risk of TLR but a high risk of stent thrombosis. Most of cardiac events related to the target vessel occur during the first year, and are associated to a revascularization without SES in another site during the first procedure.
Claude Le Feuvre; Aude Healy-Brucker; Gérard Helft; Jacques Monségu; Olivier Varenne; Christian Spaulding; Jean P Collet; Farzin Beygui; Olivier Barthélémy; Rémi Choussat; Gilles Montalescot; Jean Philippe Metzger
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2008-12-02
Journal Detail:
Title:  International journal of cardiology     Volume:  140     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-12     Completed Date:  2010-07-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  219-25     Citation Subset:  IM    
Copyright Information:
Copyright 2008 Elsevier Ireland Ltd. All rights reserved.
Cardiology Department, Pitié-Salpêtrière Hospital, 47 et 83 Bd de l'Hôpital, 75651 Paris cedex 13, France.
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MeSH Terms
Angina, Unstable / epidemiology,  therapy
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects,  statistics & numerical data
Coronary Artery Disease / epidemiology,  therapy*
Coronary Restenosis / epidemiology*
Coronary Thrombosis / epidemiology
Drug-Eluting Stents / adverse effects*,  statistics & numerical data*
Follow-Up Studies
Immunosuppressive Agents / administration & dosage*
Middle Aged
Predictive Value of Tests
Risk Factors
Sirolimus / administration & dosage*
Time Factors
Reg. No./Substance:
0/Immunosuppressive Agents; 0/Metals; 53123-88-9/Sirolimus

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