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Review
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Korean J Med. 2006;71(1):293-293.
- Comparison of cutting and conventional balloon angioplasty for In-stent restenosis: Bare metal stent vs.Drug-eluting stent
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- Comparison of cutting and conventional balloon angioplasty for In-stent restenosis: Bare metal stent vs.Drug-eluting stent
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1Department of Internal Medicine, Hanyang University College of Medicine, Seoul; 2Department of Life Science, Postech Biotech Center, Pohang University of Science and Technology, Pohang, Korea
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- Abstract
- Background In-stent restenosis (ISR) is one of major problems after stent implantation. The purpose of this study was to
compare the effectiveness of cutting and conventional balloon angioplasty for ISR of bare metal stent (BMS) and of drug-eluting
stent (DES). Methods Consecutive 136 lesions (119 patients) with ISR treated successfully by cutting balloon or conventional
balloon angioplasty were enrolled. Baseline characters and 9 month angiographic and clinical outcomes were compared. Lesions
treated by additional stent implantation were excluded and treatment modality was decided by operators discretion. Successful
angioplasty was defined as residual stenosis < 50% by visual estimation. Major adverse cardiac events (MACE) were defined
as death, myocardial infarction and target vessel revascularization. Results BMS ISR were 80 lesions (BMS ISR group) and DES
ISR were 56 lesions (DES ISR group). The clinical characteristics before percutaneous coronary intervention (PCI) were not
different between BMS ISR and DES ISR groups. Stent length was longer (38.9¡¾18.1mm vs. 20.8¡¾7.0mm, p<0.01) and stent
diameter was smaller (2.88¡¾0.27mm vs. 3.18¡¾0.55mm, p<0.01) in DES ISR group. Focal ISR was more common in DES ISR
group (80.0% vs. 58.8%, p=0.01). However, post PCI residual stenosis was not different in both groups. In 9 month angiographic
follow-up (angiographic follow-up rate, 58%), binary restenosis (42.6% vs. 28.1%, p=NS) and target lesion revascularization
(TLR) rate (12.5% vs. 8.9%, p=NS) were not significantly different between BMS ISR group and DES ISR group. MACE were
not different in both group (15.0% vs 12.5%, p=NS). There were no difference in TLR and MACE rates between cutting and
conventional balloon angioplasty in both BMS and DES groups. In a multivariate analysis, type of stent and type of treatment
were not an independent predictor for TLR after ISR treatment. Conclusion The effectiveness of cutting and conventional balloon
angioplasty for ISR of BMS and DES was not different.
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