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Interventional cardiology
The impact of lesion length and vessel size on outcomes after sirolimus-eluting stent implantation for in-stent restenosis
  1. S Habara1,
  2. K Mitsudo1,
  3. T Goto1,
  4. K Kadota1,
  5. S Fujii1,
  6. H Yamamoto1,
  7. H Kato1,
  8. S Takenaka1,
  9. Y Fuku1,
  10. S Hosogi1,
  11. A Hirono1,
  12. K Yamamoto1,
  13. H Tanaka1,
  14. D Hasegawa1,
  15. Y Nakamura1,
  16. H Tasaka1,
  17. S Otsuru1,
  18. Y Okamoto1,
  19. C Yamada1,
  20. M Miyamoto1,
  21. K Inoue1
  1. 1
    Department of Cardiology, Kurashiki Central Hospital, Kurashiki, Japan
  1. Dr Seiji Habara, Department of Cardiology, Kurashiki Central Hospital, 1-1-1 Miwa, kurashiki-shi, Okayama 710-8602, Japan; sh10461{at}kchnet.or.jp

Abstract

Objectives: We evaluated the predictors of recurrent restenosis and the impact of lesion length and vessel size on outcomes in patients treated with routine sirolimus-eluting stent (SES) implantation for in-stent restenosis (ISR) of bare-metal stent (BMS).

Methods: In this study, 250 consecutive patients with 275 lesions after SES implantation for ISR of BMS were enrolled. Follow-up angiogram was obtained in 239 patients with 258 lesions eight months after implantation (follow-up rate: 95.6%). We compared characteristics of patients and lesions between the two groups (the recurrent restenosis group and the no-restenosis group).

Results: Recurrent restenosis was angiographically documented in 43 lesions (16.7%). Recurrent restenosis was found in 30.4% with small vessel lesions (reference diameter of less than 2.5 mm, 92 lesions) and 23% with the diffuse type lesions (106 lesions). Seventy-two per cent of patients had a focal pattern of recurrent restenosis. Previously recurrent ISR lesions (odds ratio (OR) 1.94, 95% confidence interval (CI) 0.94 to 4.06, p = 0.05), reference diameter of less than 2.5 mm (OR 2.41, CI 1.05 to 5.41, p = 0.03), diffuse type restenosis (OR 4.48, CI 2.12 to 9.94, p = 0.0001) and dialysis patients (OR 4.72, CI 1.42 to 15.7, p = 0.01) were independent predictors of recurrent restenosis.

Conclusions: Small vessels, diffuse type restenosis and dialysis patients were still the predictors of recurrent restenosis in patients treated with SES for ISR of BMS.

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Footnotes

  • Competing interests: None.

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