A real world analysis of the angiographic patterns of in-stent restenosis and clinical outcome of second drug-eluting stent implantation

作者：Zhou, Jie; Chen, Hui^*

来源：International Journal of Clinical and Experimental Medicine, 2017, 10(7): 11220-11225.

• Drug-eluting stent
• in-stent restenosis
• angiographic pattern
• major adverse cardiac events (MACEs)

Objective: To investigate the medium-term outcome of patients with in-stent restenosis (ISR) who received second drug-eluting stent implantation. Methods: Totally 5993 patients received drug eluting stents during the review period, and 52 of them (74 lesions) who had a symptomatic cardiovascular event and developed ISR angiographically after they undergone angiography and received drug-eluting stents were included. Stent restenosis was classified by visual estimation on angiography. Data on major adverse cardiac events (MACEs) were retrieved and analyzed. Results: Angiography revealed that 31 patients (59.6%) had pattern I ISR, 9 patients (17.3%) had pattern II ISR, and 12 patients (23.1%) had pattern IV ISR. Twenty-four patients with ISR were treated with drug-eluting stents only, involving seven types of drug-eluting stents. Symptoms disappeared in 39 (75%) patients and were relieved in 13 (25%) patients. After 22.8 +/- 17.5 months of follow up, 7/24 (29.2%) patients developed angina pectoris requiring hospitalization, three (3/24, 12.5%) patients required revascularization, and one (1/24, 4.2%) patient had myocardial infarction and one (1/24, 4.2%) patient died. Noticeably, no (0/8) patients receiving Xience drug-eluting stent had a cardiovascular event or died. Conclusion: Second drug-eluting stent placement was effective in alleviating patient symptoms, but MACEs developed in these patients within 2 years of follow up.

• 出版日期2017
• 单位首都医科大学