Contribution of Stent Underexpansion to Recurrence After Sirolimus-Eluting Stent Implantation for In-Stent Restenosis
Kenichi Fujii,Gary S. Mintz,Yoshio Kobayashi,Stephane Carlier,Hideo Takebayashi,Takenori Yasuda,Issam Moussa,George Dangas,Roxana Mehran,Alexandra J. Lansky,Arlene Reyes,Edward M. Kreps,Michael Collins,Antonio Colombo,Gregg W. Stone,Paul S. Teirstein,Martin B. Leon,Jeffrey W. Moses +17 more
TLDR
Stent underexpansion is a significant cause of failure after sirolimus-eluting stent (SES) implantation treatment of in-stent restenosis (ISR).Abstract:
Background— We used intravascular ultrasound (IVUS) to evaluate recurrence after sirolimus-eluting stent (SES) implantation treatment of in-stent restenosis (ISR). Methods and Results— Forty-eight ISR lesions (41 patients with objective evidence of ischemia) were treated with SES. Recurrent ISR was identified in 11 lesions (all focal); repeat revascularization was performed in 10. These were compared with 16 patients (19 lesions) without recurrence as documented by angiography. Nine of 11 recurrent lesions had a minimum stent area (MSA) <5.0 mm2 versus 5 of 19 nonrecurrent lesions (P=0.003); 7 of 11 recurrent lesions had an MSA <4.0 mm2 versus 4 of 19 nonrecurrent lesions (P=0.02); and 4 of 11 recurrent lesions had an MSA <3.0 mm2 versus 1 of 19 nonrecurrent lesions (P=0.03). A gap between SESs was identified in 3 of 11 recurrences versus 1 of 19 nonrecurrent lesions. Conclusions— Stent underexpansion is a significant cause of failure after SES implantation treatment of ISR.read more
Citations
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Journal ArticleDOI
In-stent restenosis in the drug-eluting stent era.
TL;DR: Based upon the current available evidence, an algorithm for the treatment approaches to DES restenosis is proposed and its pattern is predominantly focal.
Journal ArticleDOI
Current treatment of in-stent restenosis
TL;DR: Clinical trial data is reviewed with currently available therapeutic modalities, including DES and drug-coated balloons, in patients presenting with ISR within bare-metal stents or DES in patients with in-stent restenosis.
Journal ArticleDOI
Effect of intravascular ultrasound-guided vs angiography- guided everolimus-eluting stent implantation: The IVUS-XPL randomized clinical trial
Sung Jin Hong,Sung Jin Hong,Byeong Keuk Kim,Dong Ho Shin,Chung Mo Nam,Jung Sun Kim,Young Guk Ko,Donghoon Choi,Tae-Soo Kang,Woong-Chol Kang,Ae-Young Her,Yong Hoon Kim,Seung Ho Hur,Bum-Kee Hong,Hyuck Moon Kwon,Yangsoo Jang,Myeong Ki Hong +16 more
TL;DR: The use of IVUS-guided everolimus-eluting stent implantation, compared with angiography-guided stent implants, resulted in a significantly lower rate of the composite of major adverse cardiac events at 1 year, primarily due to lower risk of target lesion revascularization.
Journal ArticleDOI
2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization
TL;DR: The guideline for coronary artery revascularization replaces the 2011 coronary artery bypass graft surgery and the 2011 and 2015 percutaneous coronary intervention guidelines, providing a patient-centric approach to guide clinicians in the treatment of patients with significant coronary artery disease undergoing coronary revascularisation as well as the supporting documentation to encourage their use as mentioned in this paper .
Journal ArticleDOI
Clinical and angiographic outcome after implantation of drug-eluting stents in bifurcation lesions with the crush stent technique: importance of final kissing balloon post-dilation.
Lei Ge,Flavio Airoldi,Ioannis Iakovou,John Cosgrave,Iassen Michev,Giuseppe Sangiorgi,Matteo Montorfano,Alaide Chieffo,Mauro Carlino,Nicola Corvaja,Antonio Colombo +10 more
TL;DR: In this article, the authors evaluated the long-term outcomes after implantation of drug-eluting stents (DES) in bifurcation lesions with the "crush" technique.
References
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Journal ArticleDOI
A Randomized Comparison of Coronary-Stent Placement and Balloon Angioplasty in the Treatment of Coronary Artery Disease
David L. Fischman,Martin B. Leon,Donald S. Baim,Richard A. Schatz,Michael P. Savage,Ian M. Penn,Katherine D. Detre,Lisa Veltri,Donald R. Ricci,Masakiyo Nobuyoshi,Michael W. Cleman,Richard R. Heuser,David Almond,Paul S. Teirstein,R. David Fish,Antonio Colombo,Jeffrey C. Brinker,Jeffrey Moses,Alex Shaknovich,John N. Hirshfeld,Stephen Bailey,Stephen E. Ellis,Randal Rake,Sheldon Goldberg +23 more
TL;DR: In selected patients, placement of an intracoronary stent, as compared with balloon angioplasty, results in an improved rate of procedural success, a lower rate of angiographically detected restenosis, a similar rate of clinical events after six months, and a less frequent need for revascularization of the original coronary lesion.
Journal ArticleDOI
Sirolimus-eluting stents versus standard stents in patients with stenosis in a native coronary artery.
Jeffrey W. Moses,Martin B. Leon,Jeffrey J. Popma,Peter J. Fitzgerald,David R. Holmes,Charles O'Shaughnessy,Ronald P. Caputo,Dean J. Kereiakes,David O. Williams,Paul S. Teirstein,Judith Jaeger,Richard E. Kuntz +11 more
TL;DR: In this randomized clinical trial involving patients with complex coronary lesions, the use of a sirolimus-eluting stent had a consistent treatment effect, reducing the rates of restenosis and associated clinical events in all subgroups analyzed.
Journal ArticleDOI
A Randomized Comparison of a Sirolimus-Eluting Stent with a Standard Stent for Coronary Revascularization
Marie-Claude Morice,Patrick W. Serruys,J. Eduardo Sousa,Jean Fajadet,Ernesto Ban Hayashi,Marco Antonio Perin,Antonio Colombo,Gerhard Schuler,Paul Barragan,Giulio Guagliumi,Ferenc Molnar,Robert Falotico +11 more
TL;DR: As compared with a standard coronary stent, a sirolimus-eluting stent shows considerable promise for the prevention of neointimal proliferation, restenosis, and associated clinical events.
Journal ArticleDOI
Angiographic Patterns of In-Stent Restenosis Classification and Implications for Long-Term Outcome
Roxana Mehran,George Dangas,Andrea Abizaid,Gary S. Mintz,Alexandra J. Lansky,Lowell F. Satler,Augusto D. Pichard,Kenneth M. Kent,Gregg W. Stone,Martin B. Leon +9 more
TL;DR: An angiographic classification of ISR according to the geographic distribution of intimal hyperplasia in reference to the implanted stent is developed and may be used for appropriate and early patient triage for clinical and investigational purposes.
Journal ArticleDOI
Impact of final stent dimensions on long-term results following sirolimus-eluting stent implantation: serial intravascular ultrasound analysis from the sirius trial.
Shinjo Sonoda,Yoshihiro Morino,Junya Ako,Mitsuyasu Terashima,Ali Hassan,Heidi N. Bonneau,Martin B. Leon,Jeffrey W. Moses,Paul G. Yock,Yasuhiro Honda,Richard E. Kuntz,Peter J. Fitzgerald +11 more
TL;DR: In this SIRIUS IVUS substudy, SES reduced both biologic variability and restenosis, resulting in increased predictability of long-term stent patency with postprocedure MSA.