Treatment of Paclitaxel-Eluting Stent Restenosis With Sirolimus-Eluting Stent Implantation - Angiographic and Clinical Outcomes

被引:16
作者
Byrne, Robert
Iijima, Raisuke
Mehilli, Julinda
Pache, Juergen
Schulz, Stefanie
Schoemig, Albert
Kastrati, Adnan
机构
[1] Tech Univ Munich, Deutsch Herzzentrum Munchen, Munich, Germany
[2] Tech Univ Munich, Med Klin Rechts Isar 1, Munich, Germany
来源
REVISTA ESPANOLA DE CARDIOLOGIA | 2008年 / 61卷 / 11期
关键词
Restenosis; Drug-eluting stent; Coronary angiography; Follow-up study;
D O I
10.1157/13127844
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction and objectives. The best way to treat drug-eluting stent restenosis remains unclear. The aim of this study was to investigate clinical and angiographic outcomes in patients who presented with paclitaxel-eluting stent restenosis and were treated by sirolimus-eluting stent implantation. Methods. The main strategy adopted at our center for the treatment of patients with paclitaxel-eluting stent restenosis was the implantation of sirolimus-eluting stents. This study included all patients treated in this manner, and data were collected prospectively. Routine angiographic follow-up was scheduled at 6-8 months after the intervention. Angiographic restenosis was defined as a restenosis >= 50% of the diameter in the segment zone. Clinical follow-up was continued for up to 2 years. The major adverse cardiac events monitored were death, myocardial infarction and target lesion revascularization. Results. The study cohort comprised 43 consecutive patients. At baseline, 33 (76.7%) had focal restenosis, while the remaining 10 (23.3%) had diffuse restenosis. Angiographic follow-up data were available for 36 (83%) patients. Binary restenosis occurred in 6 (16.7%), and instent late luminal loss was 0.32 +/- 0.54 mm. At 2 years, target lesion revascularization had been carried out in 7 (16.3%) patients, while major adverse cardiac events had occurred in 11 (25.8%). Conclusions. Implantation of a sirolimus-eluting stent as treatment for paclitaxel-eluting stent failure is a viable therapeutic strategy that was associated in this study with the durable prevention of recurrent restenosis. The 2-year revascularization and major adverse cardiac event rates were high, though they were acceptable for a cohort of such high-risk patients.
引用
收藏
页码:1134 / 1139
页数:6
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