An intravascular ultrasound analysis of the mechanisms of restenosis comparing drug-eluting stents with brachytherapy

The American Journal of Cardiology
Sang-Wook KimNeil J Weissman

Abstract

There are treatment failures after de novo drug-eluting stent (DES) implantation and after treatment with DESs or vascular brachytherapy (VBT) of in-stent restenosis (ISR) lesions. We studied 38 patients who presented with DES failure (26 patients after de novo DES implantation and 12 patients after DES treatment of ISR) and 30 patients who presented with VBT failure (all after treatment of ISR). Standard clinical data were collected and volumetric intravascular ultrasound was measured. Patients who presented with DES failures were 58.8 +/- 9.6 years of age and those who presented with VBT failures were 59.8 +/- 8.7 years of age; 60.5% of DES and 58.6% of VBT failures were in men; 31.5% of DES failures and 46.6% of VBT failures occurred in diabetic patients; and times to presentation were 210 +/- 101 days in DES failures and 510 +/- 527 days in VBT failures (p = 0.001). Minimal stent area was significantly larger in VBT than in the 2 DES failure groups (de novo DES implantation and DES treatment of ISR, p <0.0001); this was associated with more neointimal hyperplasia in VBT failures (p <0.0001). After it was normalized to stent length, intimal hyperplasia was diffusely distributed in VBT failures; conversely, DES failures were ...Continue Reading

References

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Citations

Mar 22, 2012·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Pak Hei ChanCarlo Di Mario
Dec 29, 2015·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Hiroyuki JinnouchiKenji Ando
Jun 23, 2009·Ultrasound in Medicine & Biology·Ryan K KapleGary S Mintz
Jul 29, 2010·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Inder M SinghMehdi H Shishehbor
Jun 26, 2010·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Antonio L BartorelliUNKNOWN SPIRIT II SPIRIT III Investigators
Feb 1, 2008·JACC. Cardiovascular Interventions·Enrico RomagnoliAntonio Colombo
Aug 1, 2006·Journal of the American College of Cardiology·Gary S Mintz, Neil J Weissman
Apr 24, 2016·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Peiman JamshidiFlorim Cuculi
Jun 25, 2016·JACC. Cardiovascular Interventions·Smita I NegiRon Waksman
Oct 26, 2018·Circulation. Cardiovascular Interventions·Mithun J VargheseSamin Sharma
Jan 14, 2020·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Perwaiz M MerajRajiv Sharma
Jan 17, 2020·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Michael MegalyEmmanouil S Brilakis
Jun 24, 2020·Cardiovascular Revascularization Medicine : Including Molecular Interventions·Michael MegalyEmmanouil S Brilakis

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