Characterizing the spectrum of in-stent restenosis: implications for contemporary treatment.

Characterizing the spectrum of in-stent restenosis: implications for contemporary treatment. Research Abstract Details 

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Characterizing the spectrum of in-stent restenosis: implications for contemporary treatment. Abstract Text:

Gordon E Pate,May Lee,Karin Humphries,Eric Cohen,Robert Lowe,Rebecca S Fox,Robert Teskey,Christopher E Buller,

BACKGROUND: Reports addressing treatment of in-stent restenosis (ISR) are principally derived from clinical trials. OBJECTIVES: To characterize the spectrum of ISR in an unselected population, and to explore clinical and angiographic factors determining management. METHODS: During a prespecified six-month period before the introduction of drug-eluting stents, consecutive cases of ISR that were identified during clinically driven cardiac catheterization at five hospitals offering all approved treatment modalities for ISR were prospectively registered. RESULTS: ISR was identified in 363 patients; 301 (84%) had one ISR lesion and 62 (16%) had multiple lesions. Unstable clinical presentations accounted for 51%, including 15% with ST-elevation myocardial infarction. The median interval (25th, 75th percentiles) from stent insertion to angiographic diagnosis of ISR was eight months (Q1,Q3: 4,15), with a median stented length of 18 mm (Q1,Q3: 15,28). The majority of lesions (60%) displayed a diffuse ISR pattern (Mehran types 2 and 3). ISR type was independent of time to re-presentation, diabetes, arterial territory and total stent length. Treatment included percutaneous coronary intervention (PCI) alone (n=139 [38%]), PCI with brachytherapy (n=105 [29%]), medical therapy (n=60 [17%]) and coronary artery bypass graft surgery (n=59 [16%]). Medical therapy was associated with small vessel size and recurrent ISR, and coronary artery bypass graft surgery was associated with multiple lesions, as well as diffuse, occlusive and recurrent ISR. For patients treated percutaneously, PCI treatment alone was more common for focal restenosis and after ST-elevation myocardial infarction, and brachytherapy was the more common treatment for diffuse and recurrent ISR, and stable angina. CONCLUSIONS: These data provide a benchmark description of the spectrum of ISR with which the impact of drug-eluting stents may be compared and better understood.

Characterizing the spectrum of in-stent restenosis: implications for contemporary treatment. Publishing Authors By Initials

GE Pate,M Lee,K Humphries,E Cohen,R Lowe,RS Fox,R Teskey,CE Buller,

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Characterizing the spectrum of in-stent restenosis: implications for contemporary treatment. Journal Published:

PUBLICATION TYPE: Research Support, Non-U.S. Gov

Journal: The Canadian journal of cardiology

VOLUME: 22

Page Numbers: 1223-9

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ISSN: 1916-7075

DAY: 3

MONTH: Dec

YEAR: 2006

Characterizing the spectrum of in-stent restenosis: implications for contemporary treatment. Information

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LANGUAGE: eng

NlmUniqueID: 8510280

Characterizing the spectrum of in-stent restenosis: implications for contemporary treatment. Keywords Mesh Terms:

KEYWORDS: Stents

MESH TERMS: adverse effects

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Grant and Affiliation Information for Characterizing the spectrum of in-stent restenosis: implications for contemporary treatment.

AFFILIATION: Division of Cardiology, University of British Columbia, Vancouver.

Country: Canada

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MEDLINETA: Can J Cardiol

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