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European Heart Journal 1999 20(16):1175-1181; doi:10.1053/euhj.1998.1476
Copyright © 1999 by the European Society of Cardiology.
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Restenosis after stenting of matched occluded and non-occluded coronary arteries. Should there be a difference?

J. Schofera,f1, T. Raua, M. Schlütera and D.G. Matheya

a Center for Cardiology, Othmarschen, Hamburg, Germany

1999, 1999

Abstract

Aims It is not known whether the higher restenosis rates reported after balloon angioplasty of occluded as opposed to non-occluded coronary arteries are still found after placement of coronary stents in lesions matched for factors known to affect late angiographic outcome

Methods and Results In a retrospective analysis of 1276 patients who had undergone coronary stent placement and in whom 6-month angiographic follow-up was available, we identified 144 patients with a total coronary occlusion which matched a non-occluded coronary lesion in another 144 patients. Matching lesion pairs were of the same type (de novo or restenotic), were supplied with the same type of stent, had reference vessel diameters identical within 0·3mm and stented vessel segment lengths identical within 8mm, and were located in corresponding target vessels. After stenting, statistically identical minimal lumen diameters had been achieved in both groups (occluded: 2·74±0·35mm, non-occluded: 2·77±0·32mm,P =0·45). At follow-up, minimal lumen diameters were not different (occluded: 1·65±0·77mm, non-occluded: 1·76±0·76mm,P =0·24), reflecting an identical late lumen loss for occlusions (1·09±0·76mm) and non-occluded lesions (1·01±0·70mm,P =0·38). Because of the significantly larger acute gain, the loss index was significantly lower for occluded vessels (0·40±0·27 vs 0·51±0·35,P =0·003). Corresponding restenosis rates were 33% (occluded) and 28% (non-occluded;P=0·44). For stented vessel segment lengths >18mm, restenosis rates were markedly higher (occluded: 42%, non-occluded: 36%) than for stented vessel segment lengths ≤18mm (occluded: 25%, non-occluded: 22%).

Conclusions In occluded and non-occluded coronary lesions matched for factors known to affect the angiographic outcome, no difference between the respective restenosis rates was observed within 6 months of coronary stenting. Thus, either type of coronary lesion appears to exhibit the same propensity for neointimal hyperplasia.

Key Words: Stents, occlusions, coronary disease, restenosis, angiography

f1 Correspondence: Prof Dr Joachim Schofer, Othmarscher Kirchenweg 168, 22763 Hamburg, Germany.

References

  1. Bell MR, Berger PB, Bresnahan JF, Reeder GS, Bailey KR, Holmes DR. Initial and long-term outcome of 354 patients after coronary balloon angioplasty of total coronary artery occlusions. Circulation. 1992;85:1003–1011[Abstract/Free Full Text]
  2. Violaris GA, Melkert R, Serruys PW. Long-term luminal renarrowing after successful elective coronary angioplasty of total occlusions. Circulation. 1995;91:2140–2150[Abstract/Free Full Text]
  3. Puma JA, Sketch MH, Tcheng JE. Percutaneous revascularization of chronic coronary occlusions: an overview. J Am Coll Cardiol. 1995;26:1–11[Abstract]
  4. Berger PB, Holmes DR, Ohman EM. Restenosis, reocclusion and adverse cardiovascular events after balloon angioplasty of occluded versus nonoccluded coronary arteries. J Am Coll Cardiol. 1996;27:1–7[Abstract]
  5. Goldberg SL, Colombo A, Maiello L, Borrione M, Finci L, Almagor Y. Intracoronary stent insertion after balloon angioplasty of chronic total occlusions. J Am Coll Cardiol. 1995;26:713–719[Abstract]
  6. Schwartz RS, Huber KC, Murphy JG. Restenosis and the proportional response to coronary artery injury: results in a porcine model. J Am Coll Cardiol. 1992;19:267–274[Abstract]
  7. Kuntz RE, Gibson M, Nobuyoshi M, Baim DS. Generalized model of restenosis after conventional balloon angioplasty, stenting and directional atherectomy. J Am Coll Cardiol. 1993;21:15–25[Abstract]
  8. Serruys PW, De Jaegere P, Kiemeneij F. A comparison of balloon-expandable-stent implantation with balloon angioplasty in patients with coronary artery disease. N Engl J Med. 1994;331:489–495[Abstract/Free Full Text]
  9. Fischman DL, Leon MB, Baim DS. A randomized comparison of coronary-stent placement and balloon angioplasty in the treatment of coronary artery disease. N Engl J Med. 1994;331:496–501[Abstract/Free Full Text]
  10. Sirnes PA, Golf S, Myreng Y. Stenting in Chronic Coronary Occlusion (SICCO): a randomized, controlled trial of adding stent implantation after successful angioplasty. J Am Coll Cardiol. 1996;28:1444–1451[Abstract]
  11. Mori M, Kurogane H, Hayashi T. Comparison of results of intracoronary implantation of the Plamaz-Schatz stent with conventional balloon angioplasty in chronic total coronary arterial occlusion. Am J Cardiol. 1996;78:985–989[CrossRef][ISI][Medline]
  12. Hancock J, Thomas MR, Holmberg S, Wainwright RJ, Jewitt DE. Randomised trial of elective stenting after successful percutaneous transluminal coronary angioplasty of occluded coronary arteries. Heart. 1998;79:18–23[Abstract/Free Full Text]
  13. Rau T, Schofer J, Schlüter M, Seidensticker A, Berger J, Mathey DG. Stenting of non-acute total coronary occlusions: predictors of late angiographic outcome. J Am Coll Cardiol. 1998;31:275–280[Abstract/Free Full Text]
  14. Kastrati A, Schömig A, Elezi S. Predictive factors of restenosis after coronary stent placement. J Am Coll Cardiol. 1997;30:1428–1436[Abstract]
  15. Strauss BH, Serruys PW, de Scheerder IK. Relative risk analysis of angiographic predictors of restenosis within the coronary Wallstent. Circulation. 1991;84:1636–1643[Abstract/Free Full Text]
  16. Ellis SG, Savage M, Fischman D. Restenosis after placement of Palmaz-Schatz stents in native coronary arteries: initial results of a multicenter experience. Circulation. 1992;86:1836–1844[Abstract/Free Full Text]
  17. Urban P, Meier B, Finci L, de Bruyne B, Steffenino G, Rutishauser W. Coronary wedge pressure: a predictor of restenosis after coronary balloon angioplasty. J Am Coll Cardiol. 1987;10:504–509[Abstract]
  18. Zidar FJ, Kaplan BM, O'Neill WW. Prospective, randomized trial of prolonged intracoronary urokinase infusion for chronic total occlusions in native coronary arteries. J Am Coll Cardiol. 1996;27:1406–1412[Abstract]
  19. Le Breton H, Plow EF, Topol EJ. Role of platelets in restenosis after percutaneous coronary revascularization. J Am Coll Cardiol. 1996;28:1643–1651[Abstract]
  20. Theron HT, Lambert CR, Pepine CJ. Video densitometry versus digital calipers for quantitative coronary angiography. Am J Cardiol. 1990;66:1886–1890

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Eur. Heart J., August 2, 1999; 20(16): 1142 - 1144.
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