Korean Circ J.
2003 Mar;33(3):196-204. 10.4070/kcj.2003.33.3.196.
Angiographic Outcomes and Predictors of Recurrent Restenosis after Cutting Balloon Angioplasty for the Treatment of In-Stent Restenosis
- Affiliations
-
- 1Cardiology Department, Dong-A University Medical Center, Busan, Korea.
- 2Cardiology Department, Pusan Paik Hospital, Busan, Korea.
- 3Cardiology Department, Ulsan University Hospital, Ulsan, Korea.
- 4Cardiology Department, Masan Samsung Hospital, Masan, Korea.
- 5Heart Center, Gil Medical Center, Incheon, Korea.
- 6Cardiology Department, Chonnam University Hospital, Gwangju, Korea.
- KMID: 1618730
- DOI: http://doi.org/10.4070/kcj.2003.33.3.196
Abstract
- BACKGROUND AND OBJECTIVES
The optimal treatment for in-stent restenosis(SR) s controversial, although intracoronary radiation therapy(CRT) as provided the most consistent results to date. This study was designed to assess the early and late angiographic results, and to find independent predictors of recurrent restenosis, following cutting balloon angioplasty(BA) or ISR.
SUBJECTS AND METHODS
Eighty patients(7 lesions) ith first time ISR underwent CBA and systematic follow-up(U) ngiography. A conventional balloon was used before, or after, the CBA, if required. ICRT was used in 18 lesions(1%). A multivariate logistic regression analysis was performed.(why?)
RESULTS
he ISR was focal(n=2, 37%), diffuse or proliferative(n=1, 58%) nd occlusive(n=4, 5%). Procedural success was achieved in all 87 lesions(00%). No significant edge dissection occurred. The pre- and post-procedural diameter stenoses(S) ere 81.5+/-10.8% and 6.7+/-6.0%, respectively, and the pre- and post-procedural MLD(efine MLD?) .71+/-0.44 mm and 2.85+/-0.32mm, respectively, with 2.14+/-0.44mm of acute gain. A FU angiography was performed in 54(8%) f the 69 lesions treated with CBA alone. The overall angiographic restenosis rate was 24%(3/54), with 9%(/22) n the focal ISR and 34%(1/32) n the diffuse or occlusive ISR. The FU DS and MLD were 32.0+/-23.4% and 2.1+/-0.7mm, respectively, with 0.79+/-0.69mm of late loss. The length of a restenotic lesion(R 12.2, 95% CI:1.3-115.2, p=.0286) as an independent predictor of recurrent restenosis.
CONCLUSION
CBA is a simple and efficient first line treatment for ISR, with an acceptable restenosis rate, and the length of a restenotic lesion is an independent predictor of recurrent restenosis. In diffuse or occlusive ISR, more definite treatment modalities, such as ICRT combined with CBA or debulking techniques, might be required to reduce recurrent restenosis.
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