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. 2023 Jul:52:39-46.
doi: 10.1016/j.carrev.2023.02.006. Epub 2023 Feb 16.

Prevalence, Management and Outcomes of Percutaneous Coronary Intervention for Coronary In-Stent Restenosis: Insights From the France PCI Registry

Benjamin Duband  1 , Géraud Souteyrand  2 , Jean Michel Clerc  3 , Stephan Chassaing  4 , Olivier Fichaux  5 , Pierre Marcollet  6 , Ronan Deballon  7 , Laurent Roussel  8 , Bruno Pereira  9 , Jean-Philippe Collet  10 , Philippe Commeau  11 , Guillaume Cayla  12 , Rene Koning  13 , Pascal Motreff  2 , Hakim Benamer  14 , Gregoire Rangé  8
Affiliations

Prevalence, Management and Outcomes of Percutaneous Coronary Intervention for Coronary In-Stent Restenosis: Insights From the France PCI Registry

Benjamin Duband et al. Cardiovasc Revasc Med. 2023 Jul.

Abstract

Background: Despite the evolution of stent technology, there is a non-negligible risk of in-stent restenosis (ISR) after Percutaneous coronary intervention (PCI). Large-scale registry data on the prevalence and clinical management of ISR is lacking.

Methods: The aim was to describe the epidemiology and management of patients with ≥1 ISR lesions treated with PCI (ISR PCI). Data on characteristics, management and clinical outcomes were analyzed for patients undergoing ISR PCI in the France-PCI all-comers registry.

Results: Between January 2014 and December 2018, 31,892 lesions were treated in 22,592 patients, 7.3 % of whom underwent ISR PCI. Patients undergoing ISR PCI were older (68.5 vs 67.8; p < 0.001), and more likely to have diabetes (32.7 % vs 25.4 %, p < 0.001), chronic coronary syndrome or multivessel disease. ISR PCI concerned drug eluting stents (DES) ISR in 48.8 % of cases. Patients with ISR lesions were more frequently treated with DES than drug eluting balloon or balloon angioplasty (74.2 %, 11.6 % and 12.9 %, respectively). Intravascular imaging was rarely used. At 1 year, patients with ISR had higher target lesion revascularization rates (4.3 % vs. 1.6 %; HR 2.24 [1.64-3.06]; p < 0.001).

Conclusions: In a large all-comers registry, ISR PCI was not infrequent and associated with worse prognosis than non-ISR PCI. Further studies and technical improvements are warranted to improve the outcomes of ISR PCI.

Keywords: Coronary artery disease; Coronary in-stent restenosis; Drug-eluting stents; Percutaneous coronary intervention.

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Conflict of interest statement

Declaration of competing interest GS and PM declare consulting fees for Terumo and Abbott. BD declares lecture fees for Organon and Amgen. JPC declares research funding or fees from Astrazeneca, Boston Scientific, Bristol-Myers Squibb, Cor2ed, Lead-Up, Medtronic, WebMD. GC declare research funding or fees from Abbot, Amgen, Astrazeneca, Bayer, Biotronik, Bristol-Myers Squibb, Medtronic, Microport, Pfizer, Sanofi-Aventis. PC declares consulting fees for Terumo, Bsci, Abbott, Edwards.

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