Comparison with conventional therapies of repeated sirolimus-eluting stent implantation for the treatment of drug-eluting coronary stent restenosis
Comparison with conventional therapies of repeated sirolimus-eluting stent implantation for the treatment of drug-eluting coronary stent restenosis
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DOI：
10.1016/j.amjcard.2006.07.027
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发表时间：
2006-12-01
影响因子：
2.8
通讯作者：
Park, Seung-Jung
中科院分区：
文献类型：
--
作者：
Kim, Young-Hak;Lee, Bong-Ki;Park, Seung-Jung
本研究比较了使用西罗莫司洗脱支架 (SES) 重复经皮冠状动脉介入治疗 (PCI) 与药物洗脱支架放置后再狭窄的传统疗法的安全性和有效性。连续 55 名患者有 58 个再狭窄病变（31 例接受 SES 治疗，27 例接受紫杉醇洗脱支架治疗），使用 SES（33 个病变）或传统疗法（包括单独切割球囊血管成形术（11 个病变）或冠状动脉内近距离放射治疗（14 个病变））接受 PCI。两组的基线特征相似，但 SES 组比传统组边缘受累较多（75.8% vs 36.0%，p = 0.002）且支架扩张较少（0.74 +/- 0.17 vs 0.95 +/- 0.21，p = 0.006）。 SES 组比传统组获得了更大的术后管腔增益（1.98 +/- 0.50 vs 1.22 +/- 0.48 mm，p < 0.001）。随访血管造影显示，SES 组的晚期管腔损失（0.27 +/- 0.56 vs 0.76 +/- 0.84 mm，p < 0.021）和复发性血管造影再狭窄率（3.6% vs 35.0%,,p = 0.006）均低于常规组。 SES 组的重复靶病变血运重建术后 I 年生存率为 96.7 +/- 3.2%，常规组为 91.7 +/- 5.6%（p = 0.399）。总之，与传统疗法相比，SES 的使用与较低的再狭窄复发率相关。 (c) 2006 Elsevier Inc. 保留所有权利。
This study compared the safety and efficacy of repeat percutaneous coronary intervention (PCI) using sirolimus-eluting stents (SESs) with conventional therapies for restenosis after drug-eluting stent placement. Fifty-five consecutive patients with 58 restenotic lesions (31 treated with SESs and 27 treated with paclitaxel-eluting stents) underwent PCI using SESs (33 lesions) or conventional therapies comprising cutting balloon angioplasty alone (11 lesions) or intracoronary brachytherapy (14 lesions). Baseline characteristics were similar for the 2 groups, except for greater edge involvement (75.8% vs 36.0%, p = 0.002) and less stent expansion (0.74 +/- 0.17 vs 0.95 +/- 0.21, p = 0.006) in the SES group than in the conventional group. The SES group achieved-a greater postprocedural luminal gain than the conventional group (1.98 +/- 0.50 vs 1.22 +/- 0.48 mm, p < 0.001). Follow-up angiography showed that late luminal loss (0.27 +/- 0.56 vs 0.76 +/- 0.84 mm, p 0.021) and recurrent angiographic restenosis rate (3.6% vs 35.0%,,p = 0.006) were lower in the SES group than in the conventional group. The repeated target lesion revascularization-ftee survival rates at I year were 96.7 +/- 3.2% for the SES group and 91.7 +/- 5.6% for the conventional group (p = 0.399). In conclusion, use of SESs was associated with a lower recurrent restenosis,rate compared with conventional therapies. (c) 2006 Elsevier Inc. All rights reserved.