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The Impact of Lesion Length and Vessel size on Outcomes after Sirolimus-Eluting Stent Implantation for In-Stent Restenosis
  1. Seiji Habara (sh10461{at}kchnet.or.jp)
  1. Kurashiki Central Hospital, Japan
    1. Kazuaki Mitsudo
    1. Kurashiki Central Hospital, Japan
      1. Tsuyoshi Goto
      1. Kurashiki Central Hospital, Japan
        1. Kazushige Kadota
        1. Kurashiki Central Hospital, Japan
          1. Satoki Fujii
          1. Kurashiki Central Hospital, Japan
            1. Hiroyuki Yamamoto
            1. Kurashiki Central Hospital, Japan
              1. Harumi Kato
              1. Kurashiki Central Hospital, Japan
                1. Sou Takenaka
                1. Kurashiki Central Hospital, Japan
                  1. Yasushi Fuku
                  1. Kurashiki Central Hospital, Japan
                    1. Shingo Hosogi
                    1. Kurashiki Central Hospital, Japan
                      1. Akitoshi Hirono
                      1. Kurashiki Central Hospital, Japan
                        1. Kanjo Yamamoto
                        1. Kurashiki Central Hospital, Japan
                          1. Hiroyuki Tanaka
                          1. Kurashiki Central Hospital, Japan
                            1. Daiji Hasegawa
                            1. Kurashiki Central Hospital, Japan
                              1. Yukinobu Nakamura
                              1. Kurashiki Central Hospital, Japan
                                1. Hiroshi Tasaka
                                1. Kurashiki Central Hospital, Japan
                                  1. Suguru Otsuru
                                  1. Kurashiki Central Hospital, Japan
                                    1. Yoji Okamoto
                                    1. Kurashiki Central Hospital, Japan
                                      1. Chinatsu Yamada
                                      1. Kurashiki Central Hospital, Japan
                                        1. Masakazu Miyamoto
                                        1. Kurashiki Central Hospital, Japan
                                          1. Katsumi Inoue
                                          1. Kurashiki Central Hospital, Japan

                                            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 8 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 2.5mm, 92 lesions) and 23% with the diffuse type lesions (106 lesions). Seventy-two percent 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 2.5mm (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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