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[Balloon angioplasty for restenosis of coronary endoprostheses]
N Debbas1, E Eeckhout, J C Stauffer
1Division de cardiologie, Centre hospitalier universitaire vaudois, Lausanne, Suisse.
Insights
Balloon angioplasty effectively treated coronary stent restenosis in 17 men, restoring vessel patency. This procedure demonstrated immediate clinical and angiographic success without complications.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Biomedical Engineering
Context:
- Coronary artery restenosis after stent implantation is a significant clinical challenge.
- Managing restenosis is crucial for maintaining blood flow and preventing adverse cardiac events.
- This study focuses on restenosis occurring in various coronary vessels and bypass grafts post-stenting.
Purpose:
- To evaluate the efficacy and safety of conventional balloon angioplasty for treating coronary endoprosthesis restenosis.
- To assess the immediate clinical and angiographic outcomes of balloon angioplasty in patients with significant in-stent restenosis.
- To analyze changes in minimal lumen diameter and percentage stenosis before and after angioplasty.
Summary:
- Seventeen male patients with significant coronary stent restenosis underwent balloon angioplasty.
- The procedure involved various stent types (Wallstent, Wiktor, Palmaz-Schatz) implanted for de novo stenosis, restenosis, or acute occlusion.
- Immediate clinical and angiographic success (residual stenosis ≤50%) was achieved in all patients, with no dissections reported. Minimal lumenal diameter improved significantly post-angioplasty.
Impact:
- Balloon angioplasty provides a successful treatment option for coronary stent restenosis, improving lumen diameter and reducing stenosis.
- The findings support the use of balloon angioplasty as a safe and effective intervention in managing in-stent restenosis.
- This study contributes to understanding the outcomes of interventional procedures for coronary artery disease management.
Abstract:
Between March 1991 and June 1994, the authors treated restenosis (> or = 50%) of coronary endoprostheses in 17 men aged 39 to 72 years by balloon angioplasty. The stents had been implanted for de novo stenosis in 14 patients, restenosis in 1 patient and for acute occlusion in 2 patients. The vessels treated were the left anterior descending artery (1 case), the left circumflex artery (2 cases), the right coronary artery (7 cases) and venous bypass grafts (7 cases). The endoprostheses used were 5 Wallstents in 4 patients, 13 Wiktor stents in 11 patients and 2 Palmaz-Schatz in 2 patients. Clinically, the patients with restenosis presented with class II angina (6 patients), class III (8 patients) and class IV (3 patients) of the Canadian Cardiovascular Society Classification. Conventional balloon angioplasty was performed 17 months (range: 3 to 87 months) after stent implantation and resulted in immediate clinical and angiographic success (residual stenosis < or = 50% on quantitative analysis) in all patients. In particular, there were no dissections. The minimal lumenal diameter (MLD) and percentage stenosis changed from 1.04 mm (range: 0.87 to 1.20) and 72% (range: 68 to 76) respectively before stent implantation to 2.83 mm (range: 2.46 to 3.20) and 23% (range: 20 to 27) after stent implantation. Restenosis resulted in a MLD and percentage stenosis of 0.89 mm (range: 0.77 to 1.01) and 73% (range: 69 to 78) respectively. After angioplasty of the stent, they returned to 2.68 mm (range: 2.29 to 3.06) and 27% (range: 23 to 30) respectively. The patients were not anticoagulated after angioplasty.(ABSTRACT TRUNCATED AT 250 WORDS)