Treatment of drug-eluting stent restenosis with the same versus different drug-eluting stent

Shaila Garg, Kimberly Smith, Rebecca Torguson, Teruo Okabe, Tina L Pinto Slottow, Daniel H. Steinberg, Probal Roy, Zhenyi Xue, Natalie Gevorkian, Lowell F. Satler, Kenneth M. Kent, William O. Suddath, Augusto D. Pichard, Ron Waksman*

*Corresponding author for this work

    Research output: Contribution to journalArticlepeer-review

    55 Citations (Scopus)

    Abstract

    Objective: The authors aimed to compare the clinical outcomes with repeat drug-eluting stent (DES) implantation utilizing the same type versus an alternate DES type for in-stent restenosis (ISR) of DES. Background: DES are proven as an effective treatment for bare metal ISR. Methods: A cohort of 116 patients previously treated with a sirolimus-eluting stent (SES) or a paclitaxel-eluting stent (PES) who presented with angiographic ISR were treated with repeat DES. Of these, 62 (53.4%) were treated with different DES and 54 (46.6%) were treated with the same DES. This cohort was followed for clinical events at 30 days, 6 months, and 1 year. Results: Baseline characteristics were similar except for more diabetes among patients receiving the different type of DES. Of the 116, overall 16.4% of the DES were implanted for previous ISR and 2.6% had previously received brachytherapy. At 6 months, the overall target vessel revascularization (TVR) rate was 12.2% for the entire cohort. The TVR-major adverse cardiac event (MACE) rate for the patients treated with different DES was 14.5% and 16.7% for the same DES (P = 0.750). Overall TVR rate at 1 year was 28.8%. The TVR-MACE was 32.6% for different DES and 35.0% for the same DES (P = 0.814). Conclusions: Reimplantation of DES for the treatment of DES ISR (same or different) is safe but associated with a high rate of recurrences at 1 year regardless of the initial DES type. Other treatment modalities for ISR of DES should be considered to further improve the overall TVR-MACE.

    Original languageEnglish
    Pages (from-to)9-14
    Number of pages6
    JournalCatheterization and Cardiovascular Interventions
    Volume70
    Issue number1
    DOIs
    Publication statusPublished - 1 Jul 2007

    Keywords

    • Drug-eluting stent
    • Restenosis
    • Revascularization

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