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Published on: May 14, 2013
Late restenosis of the balloon-dilated site: serial angiographic observations beyond 7 years
Takashi Yamada1, Katsumi Inoue, Naoya Hamasaki
1Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.
Insights
Long-term outcomes of balloon angioplasty show initial improvement, but restenosis recurs after 7 years. Repeat angioplasty stabilizes sites initially, but late re-narrowing is observed in stabilized balloon-dilated sites.
Area of Science:
- Cardiovascular Interventions
- Vascular Biology
- Interventional Cardiology
Background:
- Assessing the long-term fate of stabilized balloon-dilated sites is crucial for understanding restenosis.
- Retrospective analysis of outcomes following percutaneous balloon angioplasty.
Purpose of the Study:
- To evaluate the fate of stabilized balloon-dilated sites over extended periods (>7 years).
- To analyze restenosis rates and need for revascularization after initial stabilization.
Main Methods:
- Retrospective study of 171 patients undergoing percutaneous balloon angioplasty (1986).
- Angiographic evaluation at early (6 months), late (3-5 years), and long-term (7-12 years) periods.
- Analysis of diameter stenosis, reference vessel diameter, and revascularization rates.
Main Results:
- Early restenosis (<1 year) occurred in 53% of lesions.
- Stabilization was achieved with repeat angioplasty.
- Late restenosis occurred in 28% (3-5 years) and 33% (7-12 years).
- Mean diameter stenosis decreased by 6 months (50.3%) to late period (44.2%), then increased by long-term (50.3%).
- 13.8% of lesions required repeat target lesion revascularization.
Conclusions:
- Luminal diameter decreased early but regressed up to 5 years post-stabilization.
- Luminal re-narrowing re-occurred beyond 7 years after balloon angioplasty.
- Long-term fate indicates potential for late lumen loss despite initial stabilization.
Background:
The present retrospective study was performed to assess the long-term (>7 years) fate of stabilized balloon-dilated sites.
Methods And Results:
Between February and April 1986, 171 patients underwent successful percutaneous balloon angioplasty. Early restenosis (<1 year) occurred in 53%, but repeat balloon angioplasty stabilized the balloon-dilated site. The early period was defined as 6 months, late years as 3-5 years and long-term years as 7-12 years. Angiographic evaluation at both early year or late year periods (mean = 4.7 years) and long-term (mean = 10.4 years) periods following stabilization was available in 71 patients (94 lesions) with mean age of 61.7+/-8.5 years. Of the 71 patients 69.6% were male. Restenosis occurring after 1 year was defined as late restenosis. The mean diameter stenosis changed from 6 months (50.3+/-12.4%) to late-period (44.2 +/-13.2%; p < 0.05) and long-term period (50.3+/-16.1%; p < 0.001); but the reference vessel diameter did not change significantly. Late restenosis occurred in 28% (3-5 years) and 33% (7-12 years) of 94 lesions, and 13.8% of lesion required repeat target lesion revascularization. During this period, 5.3% of patients (5 lesions) underwent revascularization for new proximal or distal lesions.
Conclusions:
Decrease of luminal diameter during the early 6 months, was followed by regression after stabilization of the balloon-dilated site up to 5 years, but luminal re-narrowing occurs again over 7 years after balloon angioplasty.
