TY - JOUR
T1 - Treatment of restenotic drug-eluting stents
T2 - An intravascular ultrasound analysis
AU - Sano, Koichi
AU - Mintz, Gary S.
AU - Carlier, Stephane G.
AU - Solinas, Emilia
AU - Costa, Jose De Ribamar
AU - Qian, Jie
AU - Missel, Eduardo
AU - Shan, Shoujie
AU - Franklin-Bond, Theresa
AU - Boland, Paul
AU - Weisz, Giora
AU - Moussa, Issam
AU - Dangas, George
AU - Mehran, Roxana
AU - Lansky, Alexandra J.
AU - Kreps, Edward
AU - Collins, Michael
AU - Stone, Gregg W.
AU - Moses, Jeffrey W.
AU - Leon, Martin B.
PY - 2007/11
Y1 - 2007/11
N2 - BACKGROUND: The intravascular ultrasound (IVUS) findings during repeat intervention for drug-eluting stent (DES) restenosis have not been well described. METHODS: We identified 62 consecutive DES restenosis lesions (45 sirolimus-eluting stents and 17 paclitaxel-eluting stents) undergoing repeat intervention with pre and postintervention IVUS. Lumen, stent and intimal hyperplasia (stent minus lumen) areas were measured at the minimal lumen area (MLA) site and minimal stent area (MSA) site. RESULTS: Repeat stent implantation was performed in 55 lesions (88.7%). Overall, MLA increased from 2.3 ± 0.7 mm2 preintervention to 4.6 ± 1.6 mm2 postintervention. Preintervention MLA was seen at exactly the preintervention MSA site in 42%, while 73% of postintervention MLAs were located at the preintervention MSA site. There was a strong correlation between the preintervention MSA and the postintervention MLA (r ≤ 0.79; p < 0.001). Preintervention MSA was the strongest independent predictor of a larger postintervention MLA (coefficient 0.72; p < 0.001). CONCLUSIONS: The preintervention MSA was a major predictor of larger lumen area after repeat intervention for DES restenosis. Several IVUS studies have shown that stent dimensions do not change over time. Therefore, the MSA of the original stent implantation procedure still has the greatest impact on subsequent interventions to treat DES restenosis.
AB - BACKGROUND: The intravascular ultrasound (IVUS) findings during repeat intervention for drug-eluting stent (DES) restenosis have not been well described. METHODS: We identified 62 consecutive DES restenosis lesions (45 sirolimus-eluting stents and 17 paclitaxel-eluting stents) undergoing repeat intervention with pre and postintervention IVUS. Lumen, stent and intimal hyperplasia (stent minus lumen) areas were measured at the minimal lumen area (MLA) site and minimal stent area (MSA) site. RESULTS: Repeat stent implantation was performed in 55 lesions (88.7%). Overall, MLA increased from 2.3 ± 0.7 mm2 preintervention to 4.6 ± 1.6 mm2 postintervention. Preintervention MLA was seen at exactly the preintervention MSA site in 42%, while 73% of postintervention MLAs were located at the preintervention MSA site. There was a strong correlation between the preintervention MSA and the postintervention MLA (r ≤ 0.79; p < 0.001). Preintervention MSA was the strongest independent predictor of a larger postintervention MLA (coefficient 0.72; p < 0.001). CONCLUSIONS: The preintervention MSA was a major predictor of larger lumen area after repeat intervention for DES restenosis. Several IVUS studies have shown that stent dimensions do not change over time. Therefore, the MSA of the original stent implantation procedure still has the greatest impact on subsequent interventions to treat DES restenosis.
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M3 - Article
C2 - 17986721
AN - SCOPUS:35948997672
SN - 1042-3931
VL - 19
SP - 464
EP - 468
JO - Journal of Invasive Cardiology
JF - Journal of Invasive Cardiology
IS - 11
ER -