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Prevalence, Management and Outcomes of Percutaneous Coronary Intervention for Coronary In-Stent Restenosis: Insights

Benjamin Duband1, Géraud Souteyrand1, Jean Michel Clerc2

  • 1Cardiology Department, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.

Cardiovascular Revascularization Medicine : Including Molecular Interventions
|February 22, 2023
PubMed

Insights

In-stent restenosis (ISR) after percutaneous coronary intervention (PCI) occurs frequently and is linked to poorer outcomes. This study highlights the need for improved management strategies and further research to enhance treatment results for ISR PCI.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Device Technology

Background:

  • In-stent restenosis (ISR) remains a significant risk after percutaneous coronary intervention (PCI), despite advancements in stent technology.
  • Limited large-scale data exists on the prevalence and clinical management of ISR.

Purpose of the Study:

  • To investigate the epidemiology and management of patients undergoing ISR PCI.
  • To analyze the characteristics, treatment strategies, and clinical outcomes of ISR PCI in a real-world registry.

Main Methods:

  • Analysis of data from the France-PCI all-comers registry between January 2014 and December 2018.
  • Inclusion of patients with at least one ISR lesion treated with PCI.
  • Comparison of patient demographics, lesion characteristics, treatment modalities, and 1-year clinical outcomes between ISR PCI and non-ISR PCI groups.

Main Results:

  • ISR PCI was performed in 7.3% of treated lesions.
  • Patients undergoing ISR PCI were older and more likely to have diabetes and multivessel disease.
  • Drug-eluting stents (DES) were the predominant treatment for ISR (74.2%), though intravascular imaging was rarely utilized.
  • ISR PCI was associated with a higher rate of target lesion revascularization at 1 year compared to non-ISR PCI (4.3% vs. 1.6%).

Conclusions:

  • ISR PCI is a common occurrence in clinical practice and is associated with inferior clinical outcomes.
  • Further research and technological advancements are necessary to improve the management and outcomes of ISR PCI.
Abstract

Keywords:
Coronary artery diseaseCoronary in-stent restenosisDrug-eluting stentsPercutaneous coronary intervention

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