Document Detail

Longer-term outcomes of paclitaxel stent implantation as an initial treatment strategy for sirolimus-eluting stent restenosis.
MedLine Citation:
PMID:  20440037     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The goal of this study was to determine the long-term clinical outcomes after an initial strategy of paclitaxeleluting stent (PES) implantation for de novo sirolimus-eluting stent (SES) restenosis. BACKGROUND: The optimal treatment of drug-eluting stent (DES) restenosis is unknown. METHODS: Consecutive patients undergoing PES implantation for SES restenosis were identified. Patients were considered eligible for inclusion if: (1) the initial target lesion for the SES was de novo; (2) the SES restenotic lesion had not been previously treated; and (3) at least 1 year had passed since the PES implantation. RESULTS: A total of 130 consecutive patients with 142 restenotic SES lesions were treated with PES. Mean patient age was 66.4 +/- 11 years, diabetes was present in 37.1%, and the target lesion was focal in 67.8%. Over a median of 453 days (range, 365-789 days), out-ofhospital major adverse cardiac events occurred in 33 patients (25.4%). Out-of-hospital death occurred in 2 patients (due to sepsis and cancer), myocardial infarction in 1 patient (0.8%), and target lesion revascularization (TLR) in 30 patients (23.8%). There were no episodes of stent thrombosis. There was no difference in freedom from TLR between lesions with focal or non-focal pattern (log rank p = 0.52), although the time to recurrence was later in focal compared to non-focal lesions (323 +/- 26 days versus 216 +/- 17 days; p = 0.02). CONCLUSIONS: An initial treatment strategy of PES implantation for SES restenosis appears safe and provides reasonable outcomes at more than 1-year follow up.
Justin P Levisay; Matthew J Price; Wisam Shaba; Steve S Lee; Curtiss P Stinis; Latrice Miller; Paul S Teirstein
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  22     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-04     Completed Date:  2010-08-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  216-9     Citation Subset:  IM    
Northshore University HealthSystems, Evanston Hospital, Evanston, IL 60201, USA.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects,  mortality*
Antineoplastic Agents, Phytogenic / administration & dosage
Coronary Angiography
Coronary Artery Disease* / mortality,  radiography,  therapy
Coronary Restenosis* / mortality,  radiography,  therapy
Disease-Free Survival
Drug Resistance
Drug-Eluting Stents / adverse effects,  statistics & numerical data*
Follow-Up Studies
Middle Aged
Paclitaxel / administration & dosage*
Predictive Value of Tests
Retreatment / statistics & numerical data
Sirolimus / administration & dosage*
Survival Analysis
Treatment Outcome
Reg. No./Substance:
0/Antineoplastic Agents, Phytogenic; 33069-62-4/Paclitaxel; 53123-88-9/Sirolimus
Comment In:
J Invasive Cardiol. 2010 May;22(5):220-1   [PMID:  20440038 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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