Document Detail


Use of sirolimus-eluting stents for treatment of in-stent restenosis: long-term follow-up.
MedLine Citation:
PMID:  17700399     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aims of this study were to assess (i) the feasibility, safety and efficacy of sirolimus-eluting stents (SESs) in treating in-stent restenosis (ISR), (ii) the risk factors for recurrent ISR, and (iii) the long-term major adverse cardiac events (MACE). METHODS: Between May 2002 and April 2004, 100 consecutive patients with evidence of myocardial ischaemia and 112 ISRs in native coronary arteries were treated using SESs. We evaluated the rate of procedural and clinical success, the incidence of in-hospital and long-term MACE, the recurrence rate of ISR after 6-8 months, and the risk factors for recurrent ISR and follow-up MACE. RESULTS: Forty-five percent of the lesions were directly stented. After stent implantation, the minimal lumen diameter increased from 0.51 +/- 0.32 to 2.50 +/- 0.32 mm in the stents and to 2.30 +/- 0.35 mm in the lesions (acute gain 1.99 +/- 0.37 mm). The procedural success rate was 99%. The clinical success rate was 88%. MACE occurred in 2.0% of patients during hospitalisation and in 12.8% after a median follow-up of 15.1 months (interquartile range 8.4-19.7). The recurrence rate of ISR was 11.8% after a median follow-up of 7.7 months (interquartile range 7.4-8.4). The risk for recurrent ISR was significantly higher in patients with diabetes or hypertension, in those aged more than 65 years and in female patients, as well as in the lesions with a small minimal lumen diameter. Three-vessel disease and age were risk factors for MACE. CONCLUSIONS: This study confirms the feasibility, safety and effectiveness of using SESs to treat ISR, and identifies a risk profile for recurrent ISR and MACE.
Authors:
Nedy Brambilla; Maurizio Ferrario; Alessandra Repetto; Ezio Bramucci; Luigi Angoli; Umberto Canosi; Roberta Rosso; Marco Ferlini; Catherine Klersy; Luigi Tavazzi
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of cardiovascular medicine (Hagerstown, Md.)     Volume:  8     ISSN:  1558-2027     ISO Abbreviation:  J Cardiovasc Med (Hagerstown)     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-08-16     Completed Date:  2007-10-25     Revised Date:  2009-05-28    
Medline Journal Info:
Nlm Unique ID:  101259752     Medline TA:  J Cardiovasc Med (Hagerstown)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  699-705     Citation Subset:  IM    
Affiliation:
Cardiology Division, IRCCS Policlinico San Matteo, Piazzale Golgi 2, 27100 Pavia, Italy.
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MeSH Terms
Descriptor/Qualifier:
Coronary Restenosis / complications,  drug therapy*
Drug Delivery Systems
Feasibility Studies
Female
Follow-Up Studies
Heart Diseases / etiology
Humans
Immunosuppressive Agents / administration & dosage*
Male
Middle Aged
Risk Factors
Sirolimus / administration & dosage*
Stents
Treatment Outcome
Chemical
Reg. No./Substance:
0/Immunosuppressive Agents; 53123-88-9/Sirolimus

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


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