Contribution of stent underexpansion to recurrence after sirolimus-eluting stent implantation for in-stent restenosis

被引:236
作者
Fujii, K [1 ]
Mintz, GS [1 ]
Kobayashi, Y [1 ]
Carlier, SG [1 ]
Takebayashi, H [1 ]
Yasuda, T [1 ]
Moussa, I [1 ]
Dangas, G [1 ]
Mehran, R [1 ]
Lansky, AJ [1 ]
Reyes, A [1 ]
Kreps, E [1 ]
Collins, M [1 ]
Colombo, A [1 ]
Stone, GW [1 ]
Teirstein, PS [1 ]
Leon, MB [1 ]
Moses, JW [1 ]
机构
[1] Lenox Hill Heart & Vasc Inst, Cardiovasc Res Fdn, New York, NY 10021 USA
关键词
ultrasonics; restenosis; stents;
D O I
10.1161/01.CIR.0000121327.67756.19
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background - We used intravascular ultrasound (IVUS) to evaluate recurrence after sirolimus-eluting stent (SES) implantation treatment of in-stent restenosis (ISR). Methods and Results - Forty-eight ISR lesions ( 41 patients with objective evidence of ischemia) were treated with SES. Recurrent ISR was identified in 11 lesions ( all focal); repeat revascularization was performed in 10. These were compared with 16 patients ( 19 lesions) without recurrence as documented by angiography. Nine of 11 recurrent lesions had a minimum stent area (MSA) < 5.0 mm(2) versus 5 of 19 nonrecurrent lesions ( P = 0.003); 7 of 11 recurrent lesions had an MSA < 4.0 mm(2) versus 4 of 19 nonrecurrent lesions (P = 0.02); and 4 of 11 recurrent lesions had an MSA < 3.0 mm(2) versus 1 of 19 nonrecurrent lesions ( P = 0.03). A gap between SESs was identified in 3 of 11 recurrences versus 1 of 19 nonrecurrent lesions. Conclusions - Stent underexpansion is a significant cause of failure after SES implantation treatment of ISR.
引用
收藏
页码:1085 / 1088
页数:4
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