Advertisement





Click here for more guidelines.
CME Topic Collections Past Issues Search Current Issue Home
     

J Am Coll Cardiol, 2001; 37:1019-1025
© 2001 by the American College of Cardiology Foundation
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Goldberg, S. L.
Right arrow Articles by Colombo, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Goldberg, S. L.
Right arrow Articles by Colombo, A.

CLINICAL STUDY: INTERVENTIONAL CARDIOLOGY

Predictors of diffuse and aggressive intra-stent restenosis

Steven L. Goldberg, MD, FACC*, Arthur Loussararian, MD, FACC*, Joseph De Gregorio, MD, FACC{dagger}, Carlo Di Mario, MD{dagger}, Remo Albiero, MD{dagger} and Antonio Colombo, MD, FACC{dagger}

* Harbor-UCLA Medical Center, Torrance, California, USA
{dagger} Centro Cuore Columbus, Milan, Italy

Manuscript received November 5, 1999; revised manuscript received November 10, 2000, accepted December 13, 2000.

Reprint requests and correspondence: Dr. Steven L. Goldberg, Division of Cardiology, University of Washington School of Medicine, Box 356115, 1959 NE Pacific Street, Seattle, Washington 98195-6115
stevgold{at}u.washington.edu

OBJECTIVES

This study was performed to investigate the causes of diffuse and aggressive intra-stent restenosis.

BACKGROUND

Although restenosis is usually considered to be a dichotomous variable, there is clinical relevance to the severity of restenosis. It is not known which variables are predictive of diffuse or aggressive intra-stent restenosis.

METHODS

A consecutive series of 456 coronary lesions with in-stent restenosis was evaluated for the type of restenosis using quantitative coronary angiography. Restenosis was defined as ≥50% diameter stenosis at follow-up angiography, diffuse restenosis as a follow-up lesion length ≥10 mm and aggressive restenosis as either an increase in lesion length from the original lesion or a restenotic narrowing tighter than the original. Clinical, anatomic and procedural characteristics were evaluated for lesions associated with these types of restenosis.

RESULTS

Diffuse restenosis was associated with a smaller reference artery diameter, longer lesion length, female gender, longer stent length and the use of coil stents. Aggressive restenosis was more common in women, with the use of Wallstents and with long stent to lesion length ratios. Aggressive restenosis occurred earlier and was more closely associated with symptoms and myocardial infarctions than nonaggressive restenotic lesions.

CONCLUSIONS

Markers for diffuse restenosis were also important markers for the presence of any restenosis. A long stent to lesion length ratio is an important marker for aggressive restenosis. When severe forms of in-stent restenosis occur, they tend to present earlier and with more symptoms, including myocardial infarction. More careful consideration of the type of in-stent restenosis may aid in identifying when alternative strategies may be useful.

Abbreviations and Acronyms
  CI = confidence interval
  MI = myocardial infarction
  MLD = minimum lumen diameter
  OR = odds ratio




This article has been cited by other articles:


Home page
HeartHome page
D Perera, P Postema, R Rashid, S Patel, L Blows, M Marber, and S Redwood
Does a well developed collateral circulation predispose to restenosis after percutaneous coronary intervention? An intravascular ultrasound study
Heart, June 1, 2006; 92(6): 763 - 767.
[Abstract] [Full Text] [PDF]


Home page
ANGIOLOGYHome page
T. A. Batyraliev, I. V. Pershukov, Z. A. Niyazova-Karben, A. Karaus, O. Calenici, N. Guler, B. Eryonucu, A. Temamogullari, S. Ozgul, F. Akgul, et al.
Current Role of Laser Angioplasty of Restenotic Coronary Stents
Angiology, January 1, 2006; 57(1): 21 - 32.
[Abstract] [PDF]


Home page
HeartHome page
U Dietz, N Holz, C Dauer, and H Lambertz
Shortening the stent length reduces restenosis with bare metal stents: matched pair comparison of short stenting and conventional stenting
Heart, January 1, 2006; 92(1): 80 - 84.
[Abstract] [Full Text] [PDF]


Home page
Mayo Clin Proc.Home page
J. M. Perschbacher, G. S. Reeder, S. J. Jacobsen, S. A. Weston, J. M. Killian, A. Slobodova, and V. L. Roger
Evidence-Based Therapies for Myocardial Infarction: Secular Trends and Determinants of Practice in the Community
Mayo Clin. Proc., August 1, 2004; 79(8): 983 - 991.
[Abstract] [PDF]


Home page
J Am Coll CardiolHome page
M. Sahara, H. Kirigaya, Y. Oikawa, J. Yajima, K. Ogasawara, H. Satoh, K. Nagashima, H. Hara, Y. Nakatsu, and T. Aizawa
Arterial remodeling patterns before intervention predict diffuse in-stent restenosis: An intravascular ultrasound study
J. Am. Coll. Cardiol., November 19, 2003; 42(10): 1731 - 1738.
[Abstract] [Full Text] [PDF]


Home page
SEMIN CARDIOTHORAC VASC ANESTHHome page
S. V. Dee and H. Samady
Evolving Strategies for the Prevention and Treatment of Coronary Restenosis
Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 2003; 7(3): 281 - 293.
[Abstract] [PDF]


Home page
CirculationHome page
P. V. Oemrawsingh, G. S. Mintz, M. J. Schalij, A. H. Zwinderman, J. W. Jukema, and E. E.v.d. Wall
Intravascular Ultrasound Guidance Improves Angiographic and Clinical Outcome of Stent Implantation for Long Coronary Artery Stenoses: Final Results of a Randomized Comparison With Angiographic Guidance (TULIP Study)
Circulation, January 7, 2003; 107(1): 62 - 67.
[Abstract] [Full Text] [PDF]


Home page
CirculationHome page
A. Farb, D. K. Weber, F. D. Kolodgie, A. P. Burke, and R. Virmani
Morphological Predictors of Restenosis After Coronary Stenting in Humans
Circulation, June 25, 2002; 105(25): 2974 - 2980.
[Abstract] [Full Text] [PDF]


Home page
CirculationHome page
T. Kimura, K. Abe, S. Shizuta, K. Odashiro, Y. Yoshida, K. Sakai, K. Kaitani, K. Inoue, Y. Nakagawa, H. Yokoi, et al.
Long-Term Clinical and Angiographic Follow-Up After Coronary Stent Placement in Native Coronary Arteries
Circulation, June 25, 2002; 105(25): 2986 - 2991.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
H. C. Lowe, S. N. Oesterle, and L. M. Khachigian
Coronary in-stent restenosis: Current status and future strategies
J. Am. Coll. Cardiol., January 16, 2002; 39(2): 183 - 193.
[Abstract] [Full Text] [PDF]



 
  CME Topic Collections Past Issues Search Current Issue Home

Advertisement