Influence of residual stenosis after percutaneous coronary intervention with stent implantation on development of restenosis and stent thrombosis
The aim of this study was to assess the effects of residual stenosis after single-stent implantation on the rate of stent thrombosis, as well as restenosis within a 6-month follow-up period. Coronary angiograms of 2,157 patients with 2,523 lesions treated with a single stent were analyzed by quantit...
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| Veröffentlicht in: | The American journal of cardiology 2003-01, Vol.91 (2), p.148-153 |
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| container_title | The American journal of cardiology |
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| creator | Sick, Peter Hüttl, Tobias Niebauer, Josef Thiele, Holger Lauer, Bernward Hambrecht, Rainer Hentschel, Bettina Schuler, Gerhard |
| description | The aim of this study was to assess the effects of residual stenosis after single-stent implantation on the rate of stent thrombosis, as well as restenosis within a 6-month follow-up period. Coronary angiograms of 2,157 patients with 2,523 lesions treated with a single stent were analyzed by quantitative coronary angiography before, immediately after stent implantation, and at a planned 6-month follow-up. Lesions were classified into 4 subgroups according to the degree of residual stenosis after stent implantation: group 1, gross oversizing |
| doi_str_mv | 10.1016/S0002-9149(02)03100-4 |
| format | Article |
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Coronary angiograms of 2,157 patients with 2,523 lesions treated with a single stent were analyzed by quantitative coronary angiography before, immediately after stent implantation, and at a planned 6-month follow-up. Lesions were classified into 4 subgroups according to the degree of residual stenosis after stent implantation: group 1, gross oversizing <−15%; group 2, slight oversizing −15% to <0%; group 3, mild residual 0% to <15%; group 4, moderate residual 15% to <30%. Stent thrombosis rates were not significantly different among the 4 subgroups (group 1: 0 of 60 [0%]; group 2: 2 of 388 [0.5%]; group 3: 8 of 1,370 [0.6%]; group 4: 8 of 705 [1.1%]; p = NS for all). An adequate dosage of ticlopidine (250 mg twice daily) and aspirin (100 mg/day) led to a lower rate of stent thrombosis (6 of 2,189 cases) than inadequate dosages or missing therapy (12 of 343 cases). In 1,882 stenoses with angiographic follow-up (77.7%), gross oversizing of stents lead to a significantly higher increase of percent stenosis (p <0.001) associated with a higher restenosis rate (group 1: 34.7% vs groups 2, 3, and 4: 32.5%, 28.2%, and 29.6%, respectively). A multiple regression analysis was performed. Optimal results with regard to stent thrombosis and restenosis were achieved with mild residual stenoses between 0% and 15% after stent implantation. Oversizing of stents is no longer necessary with an adequate dosage of ticlopidine and aspirin.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/S0002-9149(02)03100-4</identifier><identifier>PMID: 12521625</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Angioplasty, Balloon, Coronary - adverse effects ; Angioplasty, Balloon, Coronary - methods ; Aspirin - therapeutic use ; Biological and medical sciences ; Cardiology ; Coronary Angiography ; Coronary Restenosis - classification ; Coronary Restenosis - diagnostic imaging ; Coronary Restenosis - etiology ; Coronary Thrombosis - classification ; Coronary Thrombosis - diagnostic imaging ; Coronary Thrombosis - etiology ; Coronary Thrombosis - prevention & control ; Diseases of the cardiovascular system ; Female ; Humans ; Intervention ; Male ; Medical sciences ; Middle Aged ; Platelet Aggregation Inhibitors - therapeutic use ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Regression Analysis ; Stents ; Ticlopidine - therapeutic use ; Transplants & implants</subject><ispartof>The American journal of cardiology, 2003-01, Vol.91 (2), p.148-153</ispartof><rights>2003 Excerpta Medica Inc.</rights><rights>2003 INIST-CNRS</rights><rights>Copyright Elsevier Sequoia S.A. 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Coronary angiograms of 2,157 patients with 2,523 lesions treated with a single stent were analyzed by quantitative coronary angiography before, immediately after stent implantation, and at a planned 6-month follow-up. Lesions were classified into 4 subgroups according to the degree of residual stenosis after stent implantation: group 1, gross oversizing <−15%; group 2, slight oversizing −15% to <0%; group 3, mild residual 0% to <15%; group 4, moderate residual 15% to <30%. Stent thrombosis rates were not significantly different among the 4 subgroups (group 1: 0 of 60 [0%]; group 2: 2 of 388 [0.5%]; group 3: 8 of 1,370 [0.6%]; group 4: 8 of 705 [1.1%]; p = NS for all). An adequate dosage of ticlopidine (250 mg twice daily) and aspirin (100 mg/day) led to a lower rate of stent thrombosis (6 of 2,189 cases) than inadequate dosages or missing therapy (12 of 343 cases). In 1,882 stenoses with angiographic follow-up (77.7%), gross oversizing of stents lead to a significantly higher increase of percent stenosis (p <0.001) associated with a higher restenosis rate (group 1: 34.7% vs groups 2, 3, and 4: 32.5%, 28.2%, and 29.6%, respectively). A multiple regression analysis was performed. Optimal results with regard to stent thrombosis and restenosis were achieved with mild residual stenoses between 0% and 15% after stent implantation. 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Coronary angiograms of 2,157 patients with 2,523 lesions treated with a single stent were analyzed by quantitative coronary angiography before, immediately after stent implantation, and at a planned 6-month follow-up. Lesions were classified into 4 subgroups according to the degree of residual stenosis after stent implantation: group 1, gross oversizing <−15%; group 2, slight oversizing −15% to <0%; group 3, mild residual 0% to <15%; group 4, moderate residual 15% to <30%. Stent thrombosis rates were not significantly different among the 4 subgroups (group 1: 0 of 60 [0%]; group 2: 2 of 388 [0.5%]; group 3: 8 of 1,370 [0.6%]; group 4: 8 of 705 [1.1%]; p = NS for all). An adequate dosage of ticlopidine (250 mg twice daily) and aspirin (100 mg/day) led to a lower rate of stent thrombosis (6 of 2,189 cases) than inadequate dosages or missing therapy (12 of 343 cases). In 1,882 stenoses with angiographic follow-up (77.7%), gross oversizing of stents lead to a significantly higher increase of percent stenosis (p <0.001) associated with a higher restenosis rate (group 1: 34.7% vs groups 2, 3, and 4: 32.5%, 28.2%, and 29.6%, respectively). A multiple regression analysis was performed. Optimal results with regard to stent thrombosis and restenosis were achieved with mild residual stenoses between 0% and 15% after stent implantation. Oversizing of stents is no longer necessary with an adequate dosage of ticlopidine and aspirin.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>12521625</pmid><doi>10.1016/S0002-9149(02)03100-4</doi><tpages>6</tpages></addata></record> |
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| identifier | ISSN: 0002-9149 |
| ispartof | The American journal of cardiology, 2003-01, Vol.91 (2), p.148-153 |
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| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals Complete |
| subjects | Aged Angioplasty, Balloon, Coronary - adverse effects Angioplasty, Balloon, Coronary - methods Aspirin - therapeutic use Biological and medical sciences Cardiology Coronary Angiography Coronary Restenosis - classification Coronary Restenosis - diagnostic imaging Coronary Restenosis - etiology Coronary Thrombosis - classification Coronary Thrombosis - diagnostic imaging Coronary Thrombosis - etiology Coronary Thrombosis - prevention & control Diseases of the cardiovascular system Female Humans Intervention Male Medical sciences Middle Aged Platelet Aggregation Inhibitors - therapeutic use Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Regression Analysis Stents Ticlopidine - therapeutic use Transplants & implants |
| title | Influence of residual stenosis after percutaneous coronary intervention with stent implantation on development of restenosis and stent thrombosis |
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