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Therapeutic Strategy for In-Stent Restenosis Based on the Restenosis Pattern After Drug-Eluting Stent Implantation

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Author(s)
Ki-Hun KimDoo-Il KimIl-Hwan KimJong-Yoon KimYang-Chun HanSang-Hoon SeolUng KimTae-Hyun YangDae-Kyeong KimDong-Soo KimSang-Hee LeeJong-Seon ParkYoung-Jo KimDong-Gu ShinYoon-Kyung ChoChang-Wook NamSeung-Ho HurKwon-Bae Kim
Keimyung Author(s)
Cho, Yun KyeongNam, Chang WookHur, Seung HoKim, Kwon Bae
Department
Dept. of Internal Medicine (내과학)
Journal Title
Korean Circulation Journal
Issued Date
2009
Volume
39
Issue
10
Keyword
Percutaneous transluminal coronary angioplastyRestenosisDrug-eluting stentCoronary restenosis
Abstract
Background and Objectives: The aim of this study was to evaluate the outcomes of repeated percutaneous coronary intervention (PCI) based on the restenosis pattern in drug-eluting stent (DES) failure. Subjects and Methods: From April 2003 to March 2006, all 67 patients (67 lesions) at our 3 centers who had DES in-stent restenosis (ISR) were enrolled. The patients were divided into 3 groups: group I had focal edge restenosis, group II had focal body restenosis, and group III had non-focal restenosis. All patients were treated with conventional PCI including plain old balloon angioplasty (POBA), cutting balloon angioplasty (CBA), and repeated DES implantation (Re-DES). Angiographic and clinical one year follow-up results for the 3 groups were evaluated. Results: Sixteen patients were enrolled in group I, 36 in group II, and 15 in group III. Baseline clinical and angiographic characteristics and the proportion of patients in each group receiving each type of treatment strategy were not significantly different among the groups. Within each group, a comparison of angiographic and clinical outcomes for each therapeutic modality revealed that restenosis rates were not statistically different. Although rates of major adverse cardiac events (MACE) were not statistically different between groups I and II, in group III, MACE were 3-fold higher for the POBA (4/4, 100.0%) and CBA (4/4, 100.0%) subgroups than for Re-DES (1/3, 33.3%) (p=0.06), but the differences did not reach statistical significance. Conclusion: The present study suggests that treatment of DES ISR should be individualized according to restenosis pattern: any PCI strategy appears appropriate for focal ISR patterns, while Re-DES might be a better choice for non-focal ISR patterns.
Keimyung Author(s)(Kor)
조윤경
남창욱
허승호
김권배
Publisher
School of Medicine
Citation
Ki-Hun Kim et al. (2009). Therapeutic Strategy for In-Stent Restenosis Based on the Restenosis Pattern After Drug-Eluting Stent Implantation. Korean Circulation Journal, 39(10), 408–413. doi: 10.4070/kcj.2009.39.10.408
Type
Article
ISSN
1738-5520
DOI
10.4070/kcj.2009.39.10.408
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/36066
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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