Interventional cardiology surgery
Clinical and angiographic outcome in patients with in-stent
restenosis and repeat target lesion revascularisation in small coronary
arteries
C M Gross, J Krämer, O Weingärtner, F Uhlich, R Dietz, J Waigand
Franz
Volhard Clinic at the Max Delbrück Centre, Charité, Campus
Berlin-Buch, Humboldt University Berlin, Germany
Correspondence to: Dr Gross email: Gross{at}fvk-berlin.de
Accepted 24 May 2000
OBJECTIVE
To evaluate the clinical
and angiographic outcome in patients with in-stent restenosis in small
coronary arteries and repeat target lesion revascularisation.
DESIGNPatients with in-stent
restenosis in coronary arteries 
2.85 mm were eligible for the
study and underwent target lesion revascularisation. Clinical and
angiographic variables were assessed during a six month follow up period.
RESULTS73 patients with 79 lesions
were treated by percutaneous transluminal coronary angioplasty (47%),
excimer laser angioplasty (25%), or restenting (28%). The mean (SD)
reference diameter before target lesion revascularisation was 2.12 (0.5) mm. Procedural success was achieved in all cases, but 57% of
the patients had restenosis after six months. The rate of further
restenosis was higher with laser angioplasty (78%) than with
restenting (47%) or balloon angioplasty alone (49%, p < 0.05).
CONCLUSIONSTreatment for in-stent
restenosis in small coronary arteries is feasible and safe, with a
second restenosis rate comparable to large coronary artery series. The
strategy of target lesion revascularisation influences further in-stent
restenosis, with an increased rate with laser angioplasty compared with
restenting and repeat dilatation alone.
Keywords: restenosis; coronary stent; small vessels; coronary artery disease
© 2000 by Heart
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