Nine-Month Angiographic and Intravascular Ultrasound Outcomes After Resolute Zotarolimus-Eluting Stent Implantation for the Treatment of In-Stent Restenosis

作者：Lee Seung Yul; Kim Byeong Keuk; Kim Jung Sun; Hong Myeong Ki; Cho Deok Kyu; Yoon Junghan; Jeon Dong Woon; Lee Nam Ho; Kwon Hyuck Moon; Jang Yangsoo^*

来源：Journal of Interventional Cardiology, 2013, 26(6): 543-549.

DOI：10.1111/joic.12073

ObjectivesWe aimed to evaluate the mid-term outcomes of resolute zotarolimus-eluting stent (R-ZES) implantation for in-stent restenosis (ISR).
BackgroundThere has been a paucity of data regarding the effects of new-generation drug-eluting stent to treat ISR.
MethodsFrom 2009 to 2010, a total of 98 patients with 98 ISR lesions were prospectively enrolled after R-ZES implantation for the treatment of ISR. Among 98 patients, 73 patients underwent follow-up angiography at 9 months. Serial intravascular ultrasound (IVUS) at both postprocedure and 9 months was evaluated in 55 patients. The overlapped segment of R-ZES was defined as the portion of R-ZES superimposed on previous stent.
ResultsLate loss and binary restenosis rate were 0.30.5mm and 5.5% at 9 months. On IVUS, the percentage of neointimal volume and maximum percentage of neointimal area were 3.9 +/- 6.3% and 17.3 +/- 15.5%, respectively. There was no significant change of vessel volume index between postprocedure and 9 months (16.9 +/- 4.7mm(3)/mm vs. 17.1 +/- 4.6mm(3)/mm, P=0.251). Late-acquired incomplete stent apposition was observed in 5 (5/55, 9.1%) cases. Compared with nonoverlapped segments of R-ZES, the overlapped did not show larger neointimal volume index (0.3 +/- 0.5mm(3)/mm vs. 0.2 +/- 0.3mm(3)/mm, P=0.187) on 9-month IVUS. During follow-up (median, 353 days), repeat target-lesion revascularization was performed in four cases, but there were no death or stent thrombosis.
ConclusionsThis study suggested that R-ZES implantation for the treatment of ISR was effective up to 9 months and showed favorable vascular responses on serial IVUS assessment.

• 出版日期2013-12