التفاصيل البيبلوغرافية
| العنوان: |
Stenting the stent: initial results and long-term clinical and angiographic outcome of coronary stenting for patients with in-stent restenosis. |
| المؤلفون: |
Alfonso, Fernando, Cequier, Angel, Alfonso, F1 (AUTHOR), Cequier, A (AUTHOR), Zueco, J (AUTHOR), Morís, C (AUTHOR), Suárez, C P (AUTHOR), Colman, T (AUTHOR), Esplugas, E (AUTHOR), Pérez-Vizcayno, M J (AUTHOR), Fernández, C (AUTHOR), Macaya, C (AUTHOR) |
| المصدر: |
American Journal of Cardiology. 2/1/2000, Vol. 85 Issue 3, p327-332. 6p. 3 Charts, 5 Graphs. |
| مصطلحات موضوعية: |
*CORONARY restenosis, *HEART disease relapse, *SURGICAL stents, *THERAPEUTICS |
| مستخلص: |
Stent restenosis constitutes a therapeutic challenge affecting an increasing number of patients. Conventional angioplasty and debulking techniques are currently used in these patients. However, the potential role of a second stent implantation in this setting (stenting the stent) remains unknown. Therefore, 65 consecutive patients (12 women, aged 62 +/- 11 years) undergoing stent implantation (42 elective and 23 unplanned) for the treatment of in-stent restenosis (diffuse [> 10 mm] in 39 [60%]) were studied. Angiographic success was obtained in all patients. Three patients developed hospital complications: 1 died from refractory heart failure and 2 suffered non-Q-wave myocardial infarctions. During follow-up (mean 17 +/- 11 months) 1 patient died (noncardiac cause) and only 9 (14%) required target vessel revascularization. Kaplan-Meier event-free survival (freedom from death, myocardial infarction, and target vessel revascularization) at 1 year was 84%. Using Cox analysis, patients with unstable symptoms, a short time to stent restenosis, nonelective stenting, and B2-C lesions tended to have poorer prognosis. After adjustment, nonelective stenting was associated (adjusted RR 2.9, 95% confidence interval [CI] 0.82 to 10.3, p = 0.09) with an adverse clinical outcome. On quantitative angiography (core lab) restenosis was found in 13 of 43 patients (30%) (75% of those eligible). Logistic regression analysis identify restenosis length (adjusted RR 1.43, 95% CI 1.04 to 2.14, p = 0.04), and time to restenosis (adjusted RR 0.67, 95% CI 0.47 to 0.94, p = 0.01) as the only independent predictors of recurrent restenosis. Thus, repeat coronary stenting is a safe and efficacious strategy for the treatment of patients with in-stent restenosis. Both elective and nonelective stenting provide excellent initial results. The long-term clinical and angiographic outcome of these patients is also favorable. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
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