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Stenting for in-stent restenosis.

D Antoniucci¹, R Valenti, G Moschi

¹Division of Cardiology, Careggi Hospital, Florence, Italy.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions

|February 7, 2001

Summary

Additional stenting effectively treats in-stent restenosis, restoring lumen area. However, unstable angina or early recurrence after the first stent may predict restenosis after repeat stenting.

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Area of Science:

Cardiovascular Interventions
Interventional Cardiology
Vascular Medicine

Background:

Intravascular ultrasound confirms additional stent implantation restores lumen area after in-stent restenosis.
Limited data exists on systematic additional stenting, especially with new stent designs.

Purpose of the Study:

To evaluate the efficacy of routine additional stent implantation for in-stent restenosis.
To identify predictors of restenosis after repeat stenting.

Main Methods:

Prospective study of 68 consecutive patients undergoing repeat stenting.
Utilized second-generation tubular stents in 84% of cases.
Assessed outcomes via clinical and angiographic follow-up.

Main Results:

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Repeat stenting was technically successful in all patients.
Mean additional stent length was 19.2 mm; 15% received multiple stents.
Postprocedure minimum lumen diameter was 3.11 mm with 2% residual stenosis.
At 10-month follow-up, major adverse events were 21% (1 death, 13 TVRs).
Angiographic restenosis rate was 32% at 79% follow-up.
Unstable angina and early recurrence predicted restenosis.

Conclusions:

Additional stenting is safe and effective for most in-stent restenosis cases.
Consider alternative treatments for patients with unstable angina or early recurrence.