Vittorio Ambrosini1, Luca Golino2, Giampaolo Niccoli3, Marco Roberto4, Pasquale Lisanti5, Roberto Ceravolo6, Guglielmo Bernardi7, Pietro Armigliato8, Gabriele Gabrielli9, Giuliano Chizzola10, Concetta De Paulis11, Filippo Crea3, Antonio Colombo12. 1. Montevergine Clinic, Mercogliano, Avellino, Italy; Ospedale S. Moscati, Avellino, Italy. 2. Montevergine Clinic, Mercogliano, Avellino, Italy; Ospedale Moriggia-Pelascini, Gravedona, Como. Electronic address: lucagolino.jazz@alice.it. 3. Policlinico A. Gemelli, Rome, Italy. 4. Internal Medicine Department, La Tour Hospital, Meyrin, Switzerland. 5. Azienda Ospedaliera S. Carlo, Potenza, Italy. 6. A.O. Pugliese-Ciaccio, Catanzaro, Italy. 7. Azienda Ospedaliera. S.M. della Misericordia, Udine, Italy. 8. Istituto Italiano Ricerche Mediche, Verona, Italy. 9. Azienda Ospedaliera Ospedali Riuniti, Ancona, Italy. 10. Ospedale "Spedali Civili", Brescia, Italy. 11. Dipartimento Cure Primarie, ATS Brianza, Italy. 12. Ospedale San Raffaele, Milan, Italy.
Abstract
AIM: Stents reduce angiographic restenosis in comparison with balloon angioplasty. The rate of in-stent restenosis (ISR), although less frequent than post-angioplasty restenosis, is becoming increasingly prevalent due to the recent exponential increase in the use of intracoronary stents. The aim of this study is to evaluate angiographic and clinical outcomes of PTCA in combination with the use of excimer laser coronary angioplasty (ELCA) and drug-eluting balloon (DEB) in treatment of in-stent restenosis (ISR). METHODS AND RESULTS: This multi-centric case-control study evaluated angiographic and clinical outcomes of PTCA with excimer laser coronary angioplasty (ELCA) and drug-eluting balloon (DEB) in 80 patients with in-stent restenosis (ISR). All patients underwent nine months of clinical and a coronary angiography follow-up. This study showed clinical and angiographic long-term success in the 91% of the patients. The incidence of myocardial infarctions and deaths was lower than the rate after plain balloon angioplasty within the stent. CONCLUSIONS: This study showed that excimer laser coronary angioplasty (ELCA) and drug-eluting balloon (DEB) may be an alternative treatment for in-stent restenosis (ISR).
AIM: Stents reduce angiographic restenosis in comparison with balloon angioplasty. The rate of in-stent restenosis (ISR), although less frequent than post-angioplasty restenosis, is becoming increasingly prevalent due to the recent exponential increase in the use of intracoronary stents. The aim of this study is to evaluate angiographic and clinical outcomes of PTCA in combination with the use of excimer laser coronary angioplasty (ELCA) and drug-eluting balloon (DEB) in treatment of in-stent restenosis (ISR). METHODS AND RESULTS: This multi-centric case-control study evaluated angiographic and clinical outcomes of PTCA with excimer laser coronary angioplasty (ELCA) and drug-eluting balloon (DEB) in 80 patients with in-stent restenosis (ISR). All patients underwent nine months of clinical and a coronary angiography follow-up. This study showed clinical and angiographic long-term success in the 91% of the patients. The incidence of myocardial infarctions and deaths was lower than the rate after plain balloon angioplasty within the stent. CONCLUSIONS: This study showed that excimer laser coronary angioplasty (ELCA) and drug-eluting balloon (DEB) may be an alternative treatment for in-stent restenosis (ISR).