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- Title
Same or Different Drug-Eluting Stent Re-Implantation for Drug-Eluting Stent Restenosis: An Assessment Including Second-Generation Drug-Eluting Stents.
- Authors
Yabe, Takayuki; Toda, Mikihito; Nakanishi, Rine; Saito, Daiga; Watanabe, Ippei; Okubo, Ryo; Amano, Hideo; Ikeda, Takanori
- Abstract
<bold>Objectives: </bold>We examined the long-term outcomes of implanting a different type of drug-eluting stent (DES), including second-generation DES, for treatment of DES-in stent restenosis (ISR).<bold>Background: </bold>Treatment for DES-ISR has not been standardized.<bold>Methods: </bold>The subjects were 80 patients with 89 lesions underwent DES implantation for DES-ISR. The patients were divided into the group of patients receiving the same DES for DES-ISR (Homo-stent: 24 patients, 25 lesions) and a different DES for DES-ISR (Hetero-stent: 56 patients, 64 lesions). The primary endpoint was survival free of major adverse cardiovascular events (MACE), including cardiac death, myocardial infarction, and target vessel revascularization (TVR). The secondary endpoint was late loss at 8-12 months follow-up. In the subgroup of patients who were treated with second-generation DES for DES-ISR, we also assessed the survival free of MACE.<bold>Results: </bold>During a mean follow-up of 45.1 ± 21.2 months, 26 patients experienced MACE. There was no significant difference in the survival free of MACE (Log rank P = 0.17). In the sub-analysis of second generation DES, MACE was significantly higher in the Homo-stent group compared to the Hetero-stent group (Log rank P = 0.04). Late loss was significantly higher in the Homo-stent group than in the Hetero-stent group (0.86 ± 1.03 vs. 0.38 ± 0.74 mm, P = 0.03). This trend was prominent in the first-generation DES group.<bold>Conclusions: </bold>Although there was no significant difference in MACE between the Hetero-stent and the Homo-stent groups including both first and second-generation DES, the sub-analysis demonstrated different DES implantation for DES-ISR significantly improved the MACE rate among patients treated with second-generation DES. (J Interven Cardiol 2016;29:311-318).
- Subjects
DRUG-eluting stents; CORONARY restenosis; CARDIOVASCULAR disease treatment; HEALTH outcome assessment; CARDIAC surgery
- Publication
Journal of Interventional Cardiology, 2016, Vol 29, Issue 3, p311
- ISSN
0896-4327
- Publication type
journal article
- DOI
10.1111/joic.12299