Clinical and angiographic follow-up after balloon angioplasty with provisional stenting for coronary in-stent restenosis

✍ Scribed by Shpend Elezi; Adnan Kastrati; Martin Hadamitzky; Josef Dirschinger; Franz-Josef Neumann; Albert Schömig

• Publisher: John Wiley and Sons
• Year: 1999
• Tongue: English
• Weight: 75 KB
• Volume: 48
• Category: Article
• ISSN: 1522-1946
• DOI: 10.1002/(sici)1522-726x(199910)48:2<151::aid-ccd6>3.0.co;2-c

✦ Synopsis

The objective of this study was to assess the angiographic and clinical outcome of patients with coronary in-stent restenosis treated with balloon angioplasty with provisional stenting. The study included 375 consecutive patients with in-stent restenosis managed with balloon angioplasty alone or combined with stenting. Clinical events were recorded during a 1-year follow-up period and quantitative analysis was performed on 6-month angiographic data. Of the 373 patients (451 lesions) with a successful procedure, 273 were treated with angioplasty alone and 100 with additional stenting. Target lesion revascularization was required in 23.7% of the patients: 20.7% in patients with angioplasty and 31.0% in patients with stenting. Angiographic restenosis rate was 38.9%: 35.8% in the angioplasty group and 47.7% in the stent group. Stenting in small vessels was associated with a much higher restenosis rate than in larger vessels (65.6% vs. 37.5%, respectively; P ‫؍‬ 0.01). Thus, repeat balloon angioplasty with provisional stenting for in-stent restenosis is a safe treatment strategy associated with a relatively favorable long-term outcome. However, the long-term results might be improved if additional stenting is avoided especially in small vessels.