In-stent restenosis: long-term outcome and predictors of subsequent target lesion revascularization after repeat balloon angioplasty
Identifieur interne : 00BF83 ( Main/Exploration ); précédent : 00BF82; suivant : 00BF84In-stent restenosis: long-term outcome and predictors of subsequent target lesion revascularization after repeat balloon angioplasty
Auteurs : Irene Bossi [France] ; Catherine Klersy [Italie] ; Alexander J. Black [Australie] ; Rosario Cortina [France] ; Remi Choussat [France] ; Bernard Cassagneau [France] ; Christian Jordan [France] ; Jean-Claude Laborde [France] ; Jean-Pierre Laurent [France] ; Monique Bernies [France] ; Jean Fajadet [France] ; Jean Marco [France]Source :
- Journal of the American College of Cardiology [ 0735-1097 ] ; 2000.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
- American college, Angiographic, Angiographic characteristics, Angioplasty, Atherectomy, Balloon angioplasty, Bossi, CABG, CI, Cardiol, Cathet cardiovasc diagn, Clinical events, Coll, Coll cardiol, Coronary artery, Coronary stenting, Cuffed tube, DCA, Diffuse restenosis, ELCA, Endoprosthesis, Follow up study, Hazard ratio, Human, Implantation, Initial stent implantation, Instrumental dilatation, Interquartile range, Jacc, Lesion, Lesion length, MI, MLD, Mehran, Minimal luminal diameter, Multivariate analysis, Myocardial infarction, PTCA, PTRA, Percutaneous, Percutaneous intervention, Predictor, Prognosis, Proliferative, Ptca, RD, Restenosis, Restenosis pattern, Restenotic, Revascularization, Rotational atherectomy, Statistical analysis, Stent, Stent restenosis, Stent restenosis jacc, Stented, Stenting, Survival, TLR, Target lesion revascularization, Total occlusion, Treatment.
- Teeft :
- American college, Angiographic, Angiographic characteristics, Angioplasty, Atherectomy, Balloon angioplasty, Bossi, Cardiol, Cathet cardiovasc diagn, Clinical events, Coll, Coll cardiol, Coronary artery, Coronary stenting, Diffuse restenosis, Hazard ratio, Implantation, Initial stent implantation, Interquartile range, Jacc, Lesion, Lesion length, Mehran, Minimal luminal diameter, Multivariate analysis, Myocardial infarction, Percutaneous, Percutaneous intervention, Predictor, Proliferative, Ptca, Restenosis, Restenosis pattern, Restenotic, Revascularization, Rotational atherectomy, Statistical analysis, Stent, Stent restenosis, Stent restenosis jacc, Stented, Stenting, Target lesion revascularization, Total occlusion.
Abstract
Abstract: OBJECTIVESWe sought to evaluate the long-term clinical outcome of patients undergoing successful balloon angioplasty for in-stent restenosis, and to determine correlates of the need for subsequent target lesion revascularization (TLR).BACKGROUNDIn-stent restenosis can be safely treated by repeat percutaneous intervention. Reported subsequent TLR rates have varied from 20% to 80% and seem related to the type of restenotic lesion.METHODSThe study population comprised 234 patients with follow-up data who were successfully treated with repeat balloon angioplasty for in-stent restenosis in 257 lesions between May 1995 and January 1998 at our institution.RESULTSClinical follow-up was available at 459 (286 to 693) days after the repeat procedure. Event-free survival was 78.5% and 74.6% at 12 and 24 months, respectively. Recurrent events occurred in 58 patients (24.8%), including 6 deaths (2.6%), 4 myocardial infarction (1.7%) and repeat target vessel revascularization in 50 patients (21.4%). Independent predictors of repeat TLR were time to in-stent restenosis <90 days (Hazard ratio 4.67, p < 0.001), minimal luminal diameter after repeat procedure (Hazard ratio 0.38, p = 0.034) and the angiographic pattern of in-stent restenosis (Hazard ratio 1.65, p = 0.036).CONCLUSIONSBalloon angioplasty is an effective means of treating in-stent restenosis. The long-term results are acceptable particularly for focal restenotic lesions. Further restenosis is more common in patients with early initial recurrence, more proliferative lesions and a poorer angiographic result from repeat angioplasty.
Url:
DOI: 10.1016/S0735-1097(00)00584-2
Affiliations:
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Cardiology</title><title level="j" type="abbrev">JAC</title><idno type="ISSN">0735-1097</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="2000">2000</date><biblScope unit="volume">35</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="1569">1569</biblScope><biblScope unit="page" to="1576">1576</biblScope></imprint><idno type="ISSN">0735-1097</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0735-1097</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>American college</term><term>Angiographic</term><term>Angiographic characteristics</term><term>Angioplasty</term><term>Atherectomy</term><term>Balloon angioplasty</term><term>Bossi</term><term>CABG</term><term>CI</term><term>Cardiol</term><term>Cathet cardiovasc diagn</term><term>Clinical events</term><term>Coll</term><term>Coll cardiol</term><term>Coronary artery</term><term>Coronary stenting</term><term>Cuffed 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jacc</term><term>Stented</term><term>Stenting</term><term>Survival</term><term>TLR</term><term>Target lesion revascularization</term><term>Total occlusion</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Artère coronaire</term><term>Dilatation instrumentale</term><term>Endoprothèse</term><term>Etude longitudinale</term><term>Homme</term><term>Pronostic</term><term>Resténose</term><term>Sonde ballonnet</term><term>Survie</term><term>Traitement</term></keywords><keywords scheme="Teeft" xml:lang="en"><term>American college</term><term>Angiographic</term><term>Angiographic characteristics</term><term>Angioplasty</term><term>Atherectomy</term><term>Balloon angioplasty</term><term>Bossi</term><term>Cardiol</term><term>Cathet cardiovasc diagn</term><term>Clinical events</term><term>Coll</term><term>Coll cardiol</term><term>Coronary artery</term><term>Coronary stenting</term><term>Diffuse restenosis</term><term>Hazard 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type="abstract" xml:lang="en">Abstract: OBJECTIVESWe sought to evaluate the long-term clinical outcome of patients undergoing successful balloon angioplasty for in-stent restenosis, and to determine correlates of the need for subsequent target lesion revascularization (TLR).BACKGROUNDIn-stent restenosis can be safely treated by repeat percutaneous intervention. Reported subsequent TLR rates have varied from 20% to 80% and seem related to the type of restenotic lesion.METHODSThe study population comprised 234 patients with follow-up data who were successfully treated with repeat balloon angioplasty for in-stent restenosis in 257 lesions between May 1995 and January 1998 at our institution.RESULTSClinical follow-up was available at 459 (286 to 693) days after the repeat procedure. Event-free survival was 78.5% and 74.6% at 12 and 24 months, respectively. Recurrent events occurred in 58 patients (24.8%), including 6 deaths (2.6%), 4 myocardial infarction (1.7%) and repeat target vessel revascularization in 50 patients (21.4%). Independent predictors of repeat TLR were time to in-stent restenosis <90 days (Hazard ratio 4.67, p < 0.001), minimal luminal diameter after repeat procedure (Hazard ratio 0.38, p = 0.034) and the angiographic pattern of in-stent restenosis (Hazard ratio 1.65, p = 0.036).CONCLUSIONSBalloon angioplasty is an effective means of treating in-stent restenosis. The long-term results are acceptable particularly for focal restenotic lesions. Further restenosis is more common in patients with early initial recurrence, more proliferative lesions and a poorer angiographic result from repeat angioplasty.</div></front></TEI><affiliations><list><country><li>Australie</li><li>France</li><li>Italie</li></country><region><li>Midi-Pyrénées</li><li>Occitanie (région administrative)</li></region><settlement><li>Toulouse</li></settlement></list><tree><country name="France"><region name="Occitanie (région administrative)"><name sortKey="Bossi, Irene" sort="Bossi, Irene" uniqKey="Bossi I" first="Irene" last="Bossi">Irene Bossi</name></region><name sortKey="Bernies, Monique" sort="Bernies, Monique" uniqKey="Bernies M" first="Monique" last="Bernies">Monique Bernies</name><name sortKey="Cassagneau, Bernard" sort="Cassagneau, Bernard" uniqKey="Cassagneau B" first="Bernard" last="Cassagneau">Bernard Cassagneau</name><name sortKey="Choussat, Remi" sort="Choussat, Remi" uniqKey="Choussat R" first="Remi" last="Choussat">Remi Choussat</name><name sortKey="Cortina, Rosario" sort="Cortina, Rosario" uniqKey="Cortina R" first="Rosario" last="Cortina">Rosario Cortina</name><name sortKey="Fajadet, Jean" sort="Fajadet, Jean" uniqKey="Fajadet J" first="Jean" last="Fajadet">Jean Fajadet</name><name sortKey="Jordan, Christian" sort="Jordan, Christian" uniqKey="Jordan C" first="Christian" last="Jordan">Christian Jordan</name><name sortKey="Laborde, Jean Claude" sort="Laborde, Jean Claude" uniqKey="Laborde J" first="Jean-Claude" last="Laborde">Jean-Claude Laborde</name><name sortKey="Laurent, Jean Pierre" sort="Laurent, Jean Pierre" uniqKey="Laurent J" first="Jean-Pierre" last="Laurent">Jean-Pierre Laurent</name><name sortKey="Marco, Jean" sort="Marco, Jean" uniqKey="Marco J" first="Jean" last="Marco">Jean Marco</name></country><country name="Italie"><noRegion><name sortKey="Klersy, Catherine" sort="Klersy, Catherine" uniqKey="Klersy C" first="Catherine" last="Klersy">Catherine Klersy</name></noRegion></country><country name="Australie"><noRegion><name sortKey="Black, Alexander J" sort="Black, Alexander J" uniqKey="Black A" first="Alexander J" last="Black">Alexander J. 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