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Clinical Trial
. 2004 Mar 9;109(9):1085-8.
doi: 10.1161/01.CIR.0000121327.67756.19. Epub 2004 Mar 1.

Contribution of stent underexpansion to recurrence after sirolimus-eluting stent implantation for in-stent restenosis

Kenichi Fujii  1 , Gary S Mintz, Yoshio Kobayashi, Stéphane G Carlier, Hideo Takebayashi, Takenori Yasuda, Issam Moussa, George Dangas, Roxana Mehran, Alexandra J Lansky, Arlene Reyes, Edward Kreps, Michael Collins, Antonio Colombo, Gregg W Stone, Paul S Teirstein, Martin B Leon, Jeffrey W Moses
Affiliations
Clinical Trial

Contribution of stent underexpansion to recurrence after sirolimus-eluting stent implantation for in-stent restenosis

Kenichi Fujii et al. Circulation. .

Abstract

Background: We used intravascular ultrasound (IVUS) to evaluate recurrence after sirolimus-eluting stent (SES) implantation treatment of in-stent restenosis (ISR).

Methods and results: Forty-eight ISR lesions (41 patients with objective evidence of ischemia) were treated with SES. Recurrent ISR was identified in 11 lesions (all focal); repeat revascularization was performed in 10. These were compared with 16 patients (19 lesions) without recurrence as documented by angiography. Nine of 11 recurrent lesions had a minimum stent area (MSA) <5.0 mm2 versus 5 of 19 nonrecurrent lesions (P=0.003); 7 of 11 recurrent lesions had an MSA <4.0 mm2 versus 4 of 19 nonrecurrent lesions (P=0.02); and 4 of 11 recurrent lesions had an MSA <3.0 mm2 versus 1 of 19 nonrecurrent lesions (P=0.03). A gap between SESs was identified in 3 of 11 recurrences versus 1 of 19 nonrecurrent lesions.

Conclusions: Stent underexpansion is a significant cause of failure after SES implantation treatment of ISR.

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