Procedural and long-term results of sirolimus-eluting stent in patients at high risk for restenosis.

Abstract:

AIM:In-stent restenosis still affects 10-50% of long-term outcome after percutaneous coronary intervention (PCI). Large clinical trials have shown that sirolimus-eluting stents (SES) have reduced restenosis rate to 0-9% in lesions at low-moderate risk. The aim of this study was to evaluate long-term clinical and angiographic outcome of SES in a real world population, at very high risk of restenosis. METHODS:Ninety lesions at high risk of restenosis (lesion length >20 mm, target vessel diameter <2.5 mm, in-stent diffuse restenosis, total occlusions and complex lesions on bypass grafts and bifurcations) were treated in 75 patients. A follow-up was scheduled at 6 months. RESULTS:Restenosis rate was 16.6% with a focal pattern of presentation in most cases. Subacute in-stent thrombosis occurred in 2.2%. Resteno-sis occurred mainly in small vessels, diabetic patients and in vessels previously treated with brachytherapy. CONCLUSION:The treatment of lesions at high risk of restenosis with SES is safe with a low restenosis rate at follow-up. An aggressive and prolonged antiplatelet regimen is mandatory because of high subacute in-stent thrombosis rates.

journal_name

Minerva Cardioangiol

authors

Presbitero P,Zavalloni D,Scatturin M,Marisco F,Pagnotta P,Boccuzzi G

keywords:

subject

Has Abstract

pub_date

2004-06-01 00:00:00

pages

189-94

issue

3

eissn

0026-4725

issn

1827-1618

journal_volume

52

pub_type

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