Copyright © 2004 by the European Society of Cardiology.
Clinical research
Treatment of in-stent restenosis using a paclitaxel-eluting stent: acute results and long-term follow-up of a matched-pair comparison with intracoronary ß-radiation therapy
a Medical Clinic I, RWTH University Hospital, Pauwelsstraße 30, 52057 Aachen, Germany
b Department of Radio-Oncology, University Hospital of Aachen, Aachen, Germany
c Heart Centre Siegburg, Siegburg, Germany
* Corresponding author. Tel.: +49-241-8089301; fax: +49-241-8880209
E-mail address: PRadke{at}ukaachen.de
Received 30 October 2003; revised 5 February 2004; accepted 13 February 2004 See Page 898 for the editorial comment on this article1
Abstract
Aims Intracoronary radiation therapy (ICR) has significantly improved the long-term outcome after treatment of diffuse in-stent restenosis (ISR). The efficacy of drug eluting stents in this setting remains less well defined. This matched-pair analysis compared the procedural and long-term clinical and angiographic outcome after treatment of diffuse ISR using a paclitaxel-eluting stent (PES) with intracoronary ß-radiation therapy.
Methods and Results Twenty-two patients receiving 25 PES (ACHIEVETM, Cook, 3.1 µg paclitaxel per square millimeter, non-polymer based coating) for ISR underwent 6-month angiographic and 12-month clinical follow-up. From a database including 141 patients (174 lesions) undergoing intracoronary ß-radiation for ISR, 25 lesions (25 patients) were pair-matched with the former group for lesion length and vessel size. PES implantation and ICR were successfull in all patients with a significantly lower postprocedural in-stent diameter stenosis in the PES group (8±12% vs. 18±8%, 
). Angiographic binary in-lesion restenosis at 6 month was 20% (5/25 lesions) in the PES group and 16% (4/25) in the ICR group (
). PES implantation resulted in significantly higher in-stent MLD at FU (2.10±0.71 vs. 1.75±0.36, 
) and a higher in-stent net gain (PES: 1.19±0.69, ICR: 0.84±0.49, 
). Two patients in the PES group and 6 patients in the ICR group experienced a target lesion revascularisation at 12-month follow-up (
).
Conclusion Implantation of a non-polymer based paclitaxel-elution stent and conventional ICR therapy for complex ISR lead to comparable acute and long-term clinical and angiographic follow-up results.
Key Words: Stent • Restenosis • Brachytherapy • Drug-eluting stent • Paclitaxel
CiteULike 
Connotea 
Del.icio.us What's this?
Related articles in EHJ:
- Remise in the treatment of in-stent restenosis
- Pieter R Stella, Peter Elsman, and Pieter A Doevendans
EHJ 2004 25: 898-899.[Extract] [Full Text]
This article has been cited by other articles:
|
|
 |
|
  B. Scheller, C. Hehrlein, W. Bocksch, W. Rutsch, D. Haghi, U. Dietz, M. Bohm, and U. Speck Treatment of Coronary In-Stent Restenosis with a Paclitaxel-Coated Balloon Catheter N. Engl. J. Med., November 16, 2006; 355(20): 2113 - 2124. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Alfonso, M.-J. Perez-Vizcayno, R. Hernandez, A. Bethencourt, V. Marti, J. R. Lopez-Minguez, J. Angel, R. Mantilla, C. Moris, A. Cequier, et al. A Randomized Comparison of Sirolimus-Eluting Stent With Balloon Angioplasty in Patients With In-Stent Restenosis: Results of the Restenosis Intrastent: Balloon Angioplasty Versus Elective Sirolimus-Eluting Stenting (RIBS-II) Trial J. Am. Coll. Cardiol., June 6, 2006; 47(11): 2152 - 2160. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. R. Holmes Jr, P. Teirstein, L. Satler, M. Sketch, J. O'Malley, J. J. Popma, R. E. Kuntz, P. J. Fitzgerald, H. Wang, E. Caramanica, et al. Sirolimus-Eluting Stents vs Vascular Brachytherapy for In-Stent Restenosis Within Bare-Metal Stents: The SISR Randomized Trial JAMA, March 15, 2006; 295(11): 1264 - 1273. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Alvarez Jr and N. K. Kapur Drug Eluting Stent Technology: A Paradigm Shift in the Treatment and Prevention of Restenosis Journal of Pharmacy Practice, December 1, 2005; 18(6): 461 - 478. [Abstract] [PDF]
|
|
|
|
|
|
A. Kastrati, J. Mehilli, N. von Beckerath, A. Dibra, J. Hausleiter, J. Pache, H. Schuhlen, C. Schmitt, J. Dirschinger, A. Schomig, et al. Sirolimus-Eluting Stent or Paclitaxel-Eluting Stent vs Balloon Angioplasty for Prevention of Recurrences in Patients With Coronary In-Stent Restenosis: A Randomized Controlled Trial JAMA, January 12, 2005; 293(2): 165 - 171. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. R Stella, P. Elsman, and P. A Doevendans Remise in the treatment of in-stent restenosis Eur. Heart J., June 1, 2004; 25(11): 898 - 899. [Full Text] [PDF]
|
|