Restenosis after successful percutaneous transluminal coronary angioplasty: serial angiographic follow-up of 229 patients

Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.

To further understand the temporal mode and mechanisms of coronary restenosis, 229 patients were studied by prospective angiographic follow-up on day 1 and at 1, 3 and 6 months and 1 year after successful percutaneous transluminal coronary angioplasty. Quantitative measurement of coronary stenosis was achieved by cinevideodensitometric analysis. Actuarial restenosis rate was 12.7% at 1 month, 43.0% at 3 months, 49.4% at 6 months and 52.5% at 1 year. In 219 patients followed up for greater than or equal to 3 months, mean stenosis diameter was 1.91 +/- 0.53 mm immediately after coronary angioplasty, 1.72 +/- 0.52 mm on day 1, 1.86 +/- 0.58 mm at 1 month and 1.43 +/- 0.67 mm at 3 months. In 149 patients followed up for greater than or equal to 6 months, mean stenosis diameter was 1.66 +/- 0.58 mm at 3 months and 1.66 +/- 0.62 mm at 6 months. In 73 patients followed up for 1 year, mean stenosis diameter was 1.65 +/- 0.56 mm at 6 months and 1.66 +/- 0.57 mm at 1 year. Thus, stenosis diameter decreased markedly between 1 month and 3 months after coronary angioplasty and reached a plateau thereafter. In conclusion, restenosis is most prevalent between 1 and 3 months and rarely occurs beyond 3 months after coronary angioplasty.

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				T. Kimura, H. Yokoi, Y. Nakagawa, T. Tamura, S. Kaburagi, Y. Sawada, Y. Sato, H. Yokoi, N. Hamasaki, H. Nosaka, et al. Three-Year Follow-Up after Implantation of Metallic Coronary-Artery Stents N. Engl. J. Med., February 29, 1996; 334(9): 561 - 567. [Abstract] [Full Text] [PDF]

				P. A. Hardhammar, H. M.M. van Beusekom, H. U. Emanuelsson, S. H. Hofma, P. A. Albertsson, P. D. Verdouw, E. Boersma, P. W. Serruys, and W. J. van der Giessen Reduction in Thrombotic Events With Heparin-Coated Palmaz-Schatz Stents in Normal Porcine Coronary Arteries Circulation, February 1, 1996; 93(3): 423 - 430. [Abstract] [Full Text]

				M. P. Savage, S. Goldberg, A. A. Bove, E. Deutsch, G. Vetrovec, R. G. Macdonald, T. Bass, J. R. Margolis, H. B. Whitworth, A. Taussig, et al. Effect of Thromboxane A2 Blockade on Clinical Outcome and Restenosis After Successful Coronary Angioplasty : Multi-Hospital Eastern Atlantic Restenosis Trial (M-HEART II) Circulation, December 1, 1995; 92(11): 3194 - 3200. [Abstract] [Full Text]

				R. L. Wilensky, K. L. March, I. Gradus-Pizlo, G. Sandusky, N. Fineberg, and D. R. Hathaway Vascular Injury, Repair, and Restenosis After Percutaneous Transluminal Angioplasty in the Atherosclerotic Rabbit Circulation, November 15, 1995; 92(10): 2995 - 3005. [Abstract] [Full Text]

				E. Camenzind, P.-P. Kint, C. Di Mario, J. Ligthart, W. van der Giessen, E. Boersma, and P. W. Serruys Intracoronary Heparin Delivery in Humans : Acute Feasibility and Long-term Results Circulation, November 1, 1995; 92(9): 2463 - 2472. [Abstract] [Full Text]

				D. J. Cohen, H. M. Krumholz, C. A. Sukin, K. K.L. Ho, R. B. Siegrist, M. Cleman, R. R. Heuser, J. A. Brinker, J. W. Moses, M. P. Savage, et al. In-Hospital and One-Year Economic Outcomes After Coronary Stenting or Balloon Angioplasty : Results From a Randomized Clinical Trial Circulation, November 1, 1995; 92(9): 2480 - 2487. [Abstract] [Full Text]

				G. Montalescot, A. Ankri, E. Vicaut, G. Drobinski, Y. Grosgogeat, and D. Thomas Fibrinogen After Coronary Angioplasty as a Risk Factor for Restenosis Circulation, July 1, 1995; 92(1): 31 - 38. [Abstract] [Full Text]

				A. E. Villa, L. A. Guzman, E. J. Poptic, V. Labhasetwar, S. D'Souza, C. L. Farrell, E. F. Plow, R. J. Levy, P. E. DiCorleto, and E. J. Topol Effects of Antisense c-myb Oligonucleotides on Vascular Smooth Muscle Cell Proliferation and Response to Vessel Wall Injury Circ. Res., April 1, 1995; 76(4): 505 - 513. [Abstract] [Full Text]

				J. A. Bittl, L. Schwartz, P. W. Serruys, The Benestent Investigators, D. L. Fischman, M. P. Savage, S. Goldberg, and E. J. Topol Coronary-Stent Placement Compared with Balloon Angioplasty N. Engl. J. Med., February 23, 1995; 332(8): 536 - 538. [Full Text]

				B. Stein, W. S. Weintraub, S. S.P. Gebhart, C. L. Cohen-Bernstein, R. Grosswald, H. A. Liberman, J. S. Douglas Jr, D. C. Morris, and S. B. King III Influence of Diabetes Mellitus on Early and Late Outcome After Percutaneous Transluminal Coronary Angioplasty Circulation, February 15, 1995; 91(4): 979 - 989. [Abstract] [Full Text]

				A. Millaire, P. de Groote, E. Decoulx, J.M. Coullet, P. Marache, J.Y. Brunet, M.E. Bertrand, and G. Ducloux Long-Term Follow-up After Peripheral and Coronary Angioplasty in Patients Undergoing Both Types of Procedure Angiology, November 1, 1994; 45(11): 923 - 929. [Abstract] [PDF]

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				E. J. Topol, F. Leya, C. A. Pinkerton, P. L. Whitlow, B. Hofling, C. A. Simonton, R. R. Masden, P. W. Serruys, M. B. Leon, D. O. Williams, et al. A Comparison of Directional Atherectomy with Coronary Angioplasty in Patients with Coronary Artery Disease N. Engl. J. Med., July 22, 1993; 329(4): 221 - 227. [Abstract] [Full Text]

				A. G. Adelman, E. A. Cohen, B. P. Kimball, R. Bonan, D. R. Ricci, J. G. Webb, L. Laramee, G. Barbeau, M. Traboulsi, B. N. Corbett, et al. A Comparison of Directional Atherectomy with Balloon Angioplasty for Lesions of the Left Anterior Descending Coronary Artery N. Engl. J. Med., July 22, 1993; 329(4): 228 - 233. [Abstract] [Full Text]

				J. A. Bittl Directional Coronary Atherectomy versus Balloon Angioplasty N. Engl. J. Med., July 22, 1993; 329(4): 273 - 274. [Full Text]