Related Experiment Video

Updated: Aug 1, 2026

Imaging In-Stent Restenosis: An Inexpensive, Reliable, and Rapid Preclinical Model
09:46

Imaging In-Stent Restenosis: An Inexpensive, Reliable, and Rapid Preclinical Model

Published on: September 14, 2009

Incidence and predictors of late total occlusion following coronary stenting

Pinak B Shah1, Donald E Cutlip, Jeffrey J Popma

  • 1Cardiovascular Division, St. Elizabeth's Medical Center, Boston, Massachusetts 02135, USA. pinak.shah@tufts.edu

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|October 23, 2003
PubMed

Insights

Total occlusion after coronary stenting is rare (1.6%), often presenting as recurrent angina. Key predictors include stenting for restenosis, longer stent length, and smaller preprocedure lumen diameter.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology

Background:

  • In-stent restenosis is a significant complication following coronary stenting.
  • Total occlusion represents a severe form of in-stent restenosis with potential adverse outcomes.

Purpose of the Study:

  • To investigate the incidence of total occlusion in stented coronary lesions.
  • To identify independent predictors of total occlusion after coronary stenting.

Main Methods:

  • Analysis of 955 coronary artery lesions from three randomized stent trials and one stent registry.
  • 6-month angiographic follow-up to assess for total occlusion.
  • Statistical analysis including univariate and stepwise multiple logistic regression.

Main Results:

  • The incidence of total occlusion was 1.6% (15/955 lesions).
  • Recurrent angina was the primary presentation (60.0%); no acute ST-segment elevation myocardial infarction was observed.
  • Independent predictors of total occlusion included stenting for restenosis (P=0.004), longer stent length (P<0.001), and smaller preprocedure minimum lumen diameter (P=0.012).

Conclusions:

  • Total occlusion is an infrequent but significant complication of coronary stenting.
  • Specific patient and procedural factors, such as prior restenosis and stent characteristics, predict its occurrence.

More Related Videos

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis04:30

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis

Published on: May 14, 2013

Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty10:03

Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty

Published on: January 28, 2020

Related Concept Videos

Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...