OBJECTIVE: To evaluate the clinical and angiographic outcome in patients with in-stent restenosis in small coronary arteries and repeat target lesion revascularisation. DESIGN: Patients with in-stent restenosis in coronary arteries < or = 2.85 mm were eligible for the study and underwent target lesion revascularisation. Clinical and angiographic variables were assessed during a six month follow up period. RESULTS: 73 patients with 79 lesions were treated by percutaneous transluminal coronary angioplasty (47%), excimer laser angioplasty (25%), or restenting (28%). The mean (SD) reference diameter before target lesion revascularisation was 2.12 (0.5) mm. Procedural success was achieved in all cases, but 57% of the patients had restenosis after six months. The rate of further restenosis was higher with laser angioplasty (78%) than with restenting (47%) or balloon angioplasty alone (49%, p < 0.05). CONCLUSIONS: Treatment for in-stent restenosis in small coronary arteries is feasible and safe, with a second restenosis rate comparable to large coronary artery series. The strategy of target lesion revascularisation influences further in-stent restenosis, with an increased rate with laser angioplasty compared with restenting and repeat dilatation alone.
OBJECTIVE: To evaluate the clinical and angiographic outcome in patients with in-stent restenosis in small coronary arteries and repeat target lesion revascularisation. DESIGN:Patients with in-stent restenosis in coronary arteries < or = 2.85 mm were eligible for the study and underwent target lesion revascularisation. Clinical and angiographic variables were assessed during a six month follow up period. RESULTS: 73 patients with 79 lesions were treated by percutaneous transluminal coronary angioplasty (47%), excimer laser angioplasty (25%), or restenting (28%). The mean (SD) reference diameter before target lesion revascularisation was 2.12 (0.5) mm. Procedural success was achieved in all cases, but 57% of the patients had restenosis after six months. The rate of further restenosis was higher with laser angioplasty (78%) than with restenting (47%) or balloon angioplasty alone (49%, p < 0.05). CONCLUSIONS: Treatment for in-stent restenosis in small coronary arteries is feasible and safe, with a second restenosis rate comparable to large coronary artery series. The strategy of target lesion revascularisation influences further in-stent restenosis, with an increased rate with laser angioplasty compared with restenting and repeat dilatation alone.
Authors: T J Ryan; D P Faxon; R M Gunnar; J W Kennedy; S B King; F D Loop; K L Peterson; T J Reeves; D O Williams; W L Winters Journal: Circulation Date: 1988-08 Impact factor: 29.690
Authors: T Akiyama; I Moussa; B Reimers; M Ferraro; Y Kobayashi; S Blengino; L Di Francesco; L Finci; C Di Mario; A Colombo Journal: J Am Coll Cardiol Date: 1998-11-15 Impact factor: 24.094
Authors: P W Serruys; P de Jaegere; F Kiemeneij; C Macaya; W Rutsch; G Heyndrickx; H Emanuelsson; J Marco; V Legrand; P Materne Journal: N Engl J Med Date: 1994-08-25 Impact factor: 91.245
Authors: F C Nath; D W Muller; S G Ellis; U Rosenschein; A Chapekis; L Quain; C Zimmerman; E J Topol Journal: J Am Coll Cardiol Date: 1993-03-01 Impact factor: 24.094
Authors: D L Fischman; M B Leon; D S Baim; R A Schatz; M P Savage; I Penn; K Detre; L Veltri; D Ricci; M Nobuyoshi Journal: N Engl J Med Date: 1994-08-25 Impact factor: 91.245