Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Jan;8(1):14-20.
Epub 2013 Jan 8.

Mid-Term Follow-Up of Drug-Eluting Stenting for In-Stent Restenosis: Bare-Metal Stents versus Drug-Eluting Stents

Negar Faramarzi  1 , Mojtaba Salarifar, Seyed Ebrahim Kassaian, Ali Mohammad Haji Zeinali, Mohammad Alidoosti, Hamidreza Pourhoseini, Ebrahim Nematipour, Mohammad Reza Mousavi, Hamidreza Goodarzynejad
Affiliations

Mid-Term Follow-Up of Drug-Eluting Stenting for In-Stent Restenosis: Bare-Metal Stents versus Drug-Eluting Stents

Negar Faramarzi et al. J Tehran Heart Cent. 2013 Jan.

Abstract

Background: Despite major advances in percutaneous coronary intervention (PCI), in-stent restenosis (ISR) remains a therapeutic challenge. We sought to compare the mid-term clinical outcomes after treatment with repeat drug-eluting stent (DES) implantation ("DES sandwich" technique) with DES placement in the bare-metal stent (DES-in-BMS) in a "real world" setting.

Methods: We retrospectively identified and analyzed clinical and angiographic data on 194 patients previously treated with the DES who underwent repeat PCI for ISR with a DES or a BMS. ISR was defined, by visual assessment, as a luminal stenosis greater than 50% within the stent or within 5 mm of its edges. We recorded the occurrence of major adverse cardiac events (MACE), defined as cardiac death, non-fatal myocardial infarction, and the need for target vessel revascularization (TVR).

Results: Of the 194 study participants, 130 were men (67.0%) and the mean ± SD of age was 57.0 ± 10.4 years, ranging from 37 to 80 years. In-hospital events (death and Q-wave myocardial infarction) occurred at a similar frequency in both groups. Outcomes at twelve months were also similar between the groups with cumulative clinical MACE at one-year follow-up of 9.6% and 11.3% in the DES-in-BMS and the DES-in-DES groups, respectively (p value = 0.702). Although not significant, there was a trend toward a higher TVR rate in the intra-DES ISR group as compared to the intra-BMS ISR group (0.9% BMS vs. 5.2% DES; p value = 0.16).

Conclusion: Our study suggests that the outcome of the patients presenting with ISR did not seem to be different between the two groups of DES-in-DES and DES-in-BMS at one-year follow-up, except for a trend toward more frequent TVR in the DES-in-DES group. Repeat DES implantation for DES restenosis could be feasible and safe with a relatively low incidence of MACE at mid-term follow-up.

Keywords: Angioplasty; Drug-eluting stent; Graft occlusion, vascular; Prognosis; Treatment outcome.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Kaplan-Meier estimations of total major adverse cardiac events-free survival MACE, Major adverse cardiac events; BMS, Bare-metal stent; DES, Drug-eluting stent
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Mehran R, Dangas G, Abizaid AS, Mintz GS, Lansky AJ, Satler LF, Pichard AD, Kent KM, Stone GW, Leon MB. Angiographic patterns of in-stent restenosis: classification and implications for long-term outcome. Circulation. 1999;100:1872–1878. - PubMed
    1. Radke PW, Kaiser A, Frost C, Sigwart U. Outcome after treatment of coronary in-stent restenosis; results from a systematic review using meta-analysis techniques. Eur Heart J. 2003;24:266–273. - PubMed
    1. Dangas GD, Claessen BE, Caixeta A, Sanidas EA, Mintz GS, Mehran R. In-stent restenosis in the drug-eluting stent era. J Am Coll Cardiol. 2010;56:1897–907. - PubMed
    1. Saia F, Lemos PA, Arampatzis CA, Hoye A, Degertekin M, Tanabe K, Sianos G, Smits PC, van der Giessen WJ, de Feyter PJ, van Domburg RT, Serruys PW. Routine sirolimus eluting stent implantation for unselected in-stent restenosis: insights from the Rapamycin Eluting Stent Evaluated at Rotterdam Cardiology Hospital (RESEARCH) registry. Heart. 2004;90:1183–1188. - PMC - PubMed
    1. Dibra A, Kastrati A, Mehilli J, Pache J, Schuhlen H, von Beckerath N, Ulm K, Wessely R, Dirschinger J, Schomig A. Paclitaxel-eluting or sirolimus-eluting stents to prevent restenosis in diabetic patients. N Engl J Med. 2005;353:663–670. - PubMed

LinkOut - more resources