Treatment of restenotic drug-eluting stents: An intravascular ultrasound analysis

Koichi Sano, Gary S. Mintz, Stephane G. Carlier, Emilia Solinas, Jose De Ribamar Costa, Jie Qian, Eduardo Missel, Shoujie Shan, Theresa Franklin-Bond, Paul Boland, Giora Weisz, Issam Moussa, George Dangas, Roxana Mehran, Alexandra J. Lansky, Edward Kreps, Michael Collins, Gregg W. Stone, Jeffrey W. Moses, Martin B. Leon

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish (US)
Pages (from-to)464-468
Number of pages5
JournalJournal of Invasive Cardiology
Issue number11
StatePublished - Nov 2007
Externally publishedYes

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


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