Incidence and predictors of restenosis after sirolimus-eluting stent implantation in high-risk patients - 21/08/11
, Vicente Mainar, MD a, Pascual Bordes, MD a, Jose Valencia, MD a, Silvia Gómez, BS a, Teresa Lozano, MD bRésumé |
Background |
Sirolimus-eluting stents (SESs) have not been evaluated systematically in clinical scenarios or with the vascular morphologies associated with the highest rates of restenosis.
Methods |
Between May 2002 and August 2003, 1379 percutaneous interventions were carried out at our center, 231 with SES implantation in patients with complex coronary lesions: (1) left main trunk, (2) bifurcations, (3) long lesions, (4) calcified lesions, (5) proximal segment of the left anterior descending coronary, (6) restenotic lesions, (7) total occlusions, (8) ostial lesions, and (9) vessels <2.75 mm. Angiographic follow-up was carried out in the 6th month in 201 patients. Clinical, angiographic, and procedural variables were analyzed to assess predictors of restenosis.
Results |
Of the patients, 42.6% were diabetic and 20.2% were insulin dependent. A total of 263 lesions was treated. Mean lesion length was 16.5 ± 11 mm and mean vessel diameter was 2.54 ± 0.7 mm. A total of 327 stents was implanted to fully cover the entire lesion, in most cases after predilatation (89.1%). The mean segment length covered by the stent was 26 ± 12 mm and the stent length/lesion length ratio was 1.7 ± 0.9. Binary restenosis was found in 8.7%, but there was no edge restenosis. The only predictors of restenosis were female sex (OR 3.44, 95% CI 1.31-8.99, P = .011) and lesion length >30 mm (OR 3.39, 95% CI 1.07-10.77, P = .038).
Conclusions |
In scenarios that usually entail high restenotic risk in patients with conventional stent implantation, SESs had a low incidence of restenosis without edge complications.
Le texte complet de cet article est disponible en PDF.Plan
Vol 150 - N° 3
P. 536-542 - septembre 2005 Retour au numéro
Article précédent
- Magnetic resonance angiography of coronary arteries with a 3-dimensional magnetization-prepared true fast imaging with steady-state precession sequence compared with conventional coronary angiography
- Nina Man-ching So, Wynnie Wai-man Lam, Debiao Li, Anna Kin-Yin Chan, John Elsby Sanderson, Constantine Metreweli
- Radial versus femoral access for emergent percutaneous coronary intervention with adjunct glycoprotein IIb/IIIa inhibition in acute myocardial infarction—the RADIAL-AMI pilot randomized trial
- Warren J. Cantor, Geoff Puley, Madhu K. Natarajan, Vlad Dzavik, Mina Madan, Anne Fry, Hahn Hoe Kim, James L. Velianou, Nurry Pirani, Bradley H. Strauss, Robert J. Chisholm
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?