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Clinical and angiographic outcome in patients with in-stent restenosis and repeat target lesion revascularisation in small coronary arteries
  1. C M Gross,
  2. J Krämer,
  3. O Weingärtner,
  4. F Uhlich,
  5. R Dietz,
  6. J Waigand
  1. Franz Volhard Clinic at the Max Delbrück Centre, Charité, Campus Berlin-Buch, Humboldt University Berlin, Germany
  1. Dr Gross email: Gross{at}fvk-berlin.de

Abstract

OBJECTIVE To evaluate the clinical and angiographic outcome in patients with in-stent restenosis in small coronary arteries and repeat target lesion revascularisation.

DESIGN Patients 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.

RESULTS 73 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).

CONCLUSIONS Treatment 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.

  • restenosis
  • coronary stent
  • small vessels
  • coronary artery disease

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