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Updated: Jul 5, 2026
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Re-stenosis after drug-eluting stents in cardiac allograft vasculopathy
Raed A Aqel1, Bryan J Wells, Fadi G Hage
1Division of Cardiovascular Disease, University of Alabama at Birmingham, Alabama 35294, USA. raed.aqel@med.va.gov
Insights
Drug-eluting stents (DES) show favorable outcomes for treating cardiac allograft vasculopathy (CAV) in heart transplant patients. This study identified predictors of re-stenosis, suggesting an aggressive DES strategy may improve long-term results.
Area of Science:
- Cardiology
- Transplantation Medicine
- Interventional Cardiology
Background:
- Cardiac allograft vasculopathy (CAV) is a major cause of mortality post-heart transplantation.
- Traditional revascularization methods like balloon angioplasty and bare metal stents have high re-stenosis rates.
- Drug-eluting stents (DES) show promise in managing CAV with limited existing data.
Purpose of the Study:
- To evaluate the re-stenosis rate of DES in patients with CAV.
- To identify predictors associated with DES re-stenosis in this population.
Main Methods:
- Retrospective follow-up of cardiac transplant patients who received DES for de novo coronary lesions.
- Coronary angiography used to define re-stenosis (> or =50% lumen diameter narrowing at the DES site).
- Analysis of patient and lesion characteristics to identify re-stenosis predictors.
Main Results:
- 35 patients underwent percutaneous coronary intervention (PCI) on 84 lesions.
- The overall re-stenosis rate was 31% at a mean follow-up of 22 months.
- Predictors of re-stenosis included non-white race, ischemic etiology, symptom-driven intervention, and severe target lesion stenosis (> or =90%).
Conclusions:
- DES demonstrate favorable outcomes for treating CAV in heart transplant recipients.
- An aggressive approach using DES for CAV management may offer good long-term results compared to alternative therapies.
Background:
Cardiac allograft vasculopathy (CAV) constitutes a primary cause of death after heart transplantation. Balloon angioplasty and bare metal stents have been used for revascularization but they are associated with a high risk of re-stenosis. Limited data have shown favorable results with drug-eluting stents (DES). This study examines the rate of re-stenosis for DES in CAV as well as predictors for its occurrence.
Methods:
Cardiac transplant patients who received at least one DES for a previously untreated coronary lesion were included. These patients were retrospectively followed until February 2007. Re-stenosis was defined as >or=50% lumen diameter narrowing on coronary angiography at the site of the DES.
Results:
During the study period, 35 patients underwent percutaneous coronary intervention (PCI) on a total of 84 de novo lesions. The mean follow-up was 22 +/- 14 months. Twenty-six (31%) lesions developed re-stenosis during follow-up. Re-stenosis rates were 18%, 21% and 26% at 6, 9 and 12 months, respectively. Predictors of re-stenosis included non-white race, ischemic etiology, intervention precipitated by symptoms and severe stenosis (>/=90% stenosis) of the target lesion.
Conclusions:
Use of DES has a favorable outcome when used in heart transplant patients for the treatment of CAV. An aggressive strategy for the treatment of CAV using DES may provide good long-term outcome compared with other available therapies.
