Mechanisms and Patterns of Intravascular Ultrasound In-Stent Restenosis Among Bare Metal Stents and First- and Second-Generation Drug-Eluting Stents

The American Journal of Cardiology
Kosaku GotoAkiko Maehara

Abstract

The most common causes of in-stent restenosis (ISR) are intimal hyperplasia and stent under expansion. The purpose of this study was to use intravascular ultrasound (IVUS) to compare the ISR mechanisms of bare metal stents (BMS), first-generation drug-eluting stents (DES), and second-generation DES. There were 298 ISR lesions including 52 BMS, 73 sirolimus-eluting stents, 52 paclitaxel-eluting stents, 16 zotarolimus-eluting stents, and 105 everolimus-eluting stent. Mean patient age was 66.6 ± 1.1 years, 74.2% were men, and 48.3% had diabetes mellitus. BMS restenosis presented later (70.0 ± 66.7 months) with more intimal hyperplasia compared with DES (BMS 58.6 ± 15.5%, first-generation DES 52.6 ± 20.9%, second-generation DES 48.2 ± 22.2%, p = 0.02). Although reference lumen areas were similar in BMS and first- and second-generation DES, restenotic DES were longer (BMS 21.8 ± 13.5 mm, first-generation DES 29.4 ± 16.1 mm, second-generation DES 32.1 ± 18.7 mm, p = 0.003), and stent areas were smaller (BMS 7.2 ± 2.4 mm(2), first-generation DES 6.1 ± 2.1 mm(2), second-generation DES 5.7 ± 2.0 mm(2), p <0.001). Stent fracture was seen only in DES (first-generation DES 7 [5.0%], second-generation DES 8 [7.4%], p = 0.13). In conclusion,...Continue Reading

References

Jun 7, 2002·The New England Journal of Medicine·Marie-Claude MoriceUNKNOWN RAVEL Study Group. Randomized Study with the Sirolimus-Coated Bx Velocity Balloon-Expandable Stent in the Treatment of Patie
Oct 3, 2003·The New England Journal of Medicine·Jeffrey W MosesUNKNOWN SIRIUS Investigators
Apr 20, 2007·International Journal of Cardiology·Patrick OhlmannNeil J Weissman
Oct 30, 2007·Circulation Journal : Official Journal of the Japanese Circulation Society·Masanori OkumuraHitoshi Hishida
Dec 2, 2008·International Journal of Cardiology·Emine BilenGokturk Ipek
Jan 27, 2011·Circulation. Cardiovascular Interventions·Soo-Jin KangSeung-Jung Park
May 29, 2012·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Giovanni Paolo TalaricoFilippo Crea
Sep 27, 2012·Circulation. Cardiovascular Interventions·Shoichi KuramitsuMasakiyo Nobuyoshi
Dec 19, 2012·Circulation·Patrick T O'GaraUNKNOWN American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines
Mar 22, 2014·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Shinji InabaAkiko Maehara

❮ Previous
Next ❯

Citations

Jan 20, 2016·Current Treatment Options in Cardiovascular Medicine·Patrick M LooserDmitriy N Feldman
Mar 23, 2017·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Lei SongAkiko Maehara
Jun 26, 2018·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Lorenz RäberGiulio Guagliumi
Aug 31, 2018·Circulation Journal : Official Journal of the Japanese Circulation Society·Katsuya MiuraKazushige Kadota
Nov 30, 2018·Circulation Journal : Official Journal of the Japanese Circulation Society·Daisuke NakamuraMasami Nishino
Jan 27, 2019·Journal of Personalized Medicine·Theodore G PapaioannouDimitrios Tousoulis
Jan 31, 2017·Circulation Journal : Official Journal of the Japanese Circulation Society·Hiroyuki JinnouchiKenji Ando
Jun 14, 2017·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Rodrigue StettlerChristos V Bourantas
May 26, 2017·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Alberto MinacapelliBernardo Cortese
Jul 28, 2019·Circulation. Cardiovascular Interventions·Evan ShlofmitzRon Waksman
Sep 20, 2020·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Florian BlachutzikHolger M Nef
Oct 31, 2020·The International Journal of Cardiovascular Imaging·Akito KawamuraJun Tanouchi
Nov 9, 2020·Cardiovascular Revascularization Medicine : Including Molecular Interventions·Jonathan CurioManel Sabaté
Jul 13, 2021·Cardiovascular Revascularization Medicine : Including Molecular Interventions·Evan ShlofmitzRon Waksman

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiovascular Diseases: Risk Factors

Cardiovascular disease is a significant health concern. Risk factors include hypertension, obesity, dyslipidemia and smoking. Women who are postmenopausal are at an increased risk of heart disease. Here is the latest research for risk factors of cardiovascular disease.

Auditory Perception

Auditory perception is the ability to receive and interpret information attained by the ears. Here is the latest research on factors and underlying mechanisms that influence auditory perception.

Antianginal Drugs: Mechanisms of Action

Antianginal drugs, including nitrates, beta-blockers, and calcium channel blockers, are used in the treatment of angina pectoris. Here is the latest research on their use and their mechanism of action.