Comparison of Plain Balloon and Cutting Balloon Angioplasty for the Treatment of Restenosis With Drug-Eluting Stents vs Bare Metal Stents
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概要
- 論文の詳細を見る
Background: The efficacy of cutting or plain balloon angioplasty (CBA or PBA) has not been analyzed for the treatment of drug-eluting stent (DES) restenosis vs bare metal stent (BMS) restenosis. Methods and Results: The 252 in-stent restenosis (ISR) lesions in 224 consecutive patients treated by CBA (n=167) or PBA (n=85) between July 2002 and December 2007 were analyzed. At 6-month angiographic and 12-month clinical follow-up, CBA and PBA showed similar efficacies: repeat-ISR (37.0% vs 37.8%, P=0.90), late loss (0.62±0.60 vs 0.61±0.47 mm, P=0.92), and target lesion revascularization (18.3% vs 22.4%, P=0.50). This comparable efficacy was maintained for treatment in the DES-ISR and BMS-ISR subgroups. However, target lesion-related myocardial infarction (n=9) occurred more frequently in the CBA than in the PBA arm (6.2% vs 0%, P=0.03), most of which developed early after ISR treatment (n=7; 54±26 days). Independent predictors of repeat-ISR were diffuse ISR and smaller pretreatment minimal lumen diameter, both of which might imply heavier plaque burden in the ISR group. Conclusions: Plain or cutting balloon angioplasty for ISR seems to be comparable, as the angiographic or clinical endpoints were not affected by initial stent type but by parameters related to the plaque burden of the ISR lesion. However, CBA might be associated with higher risk of myocardial infarction than PBA, suggesting more attention to dual-antiplatelet therapy after its use for ISR.
著者
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Shin Dong-Ho
Cardiovascular Center, Seoul National University Hospital
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Kang Hyun-Jae
Cardiovascular Center, Seoul National University Hospital
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Koo Bon-Kwon
Cardiovascular Center, Seoul National University Hospital
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Kim Hyo-Soo
Cardiovascular Center, Seoul National University Hospital
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Youn Tae-Jin
Cardiovascular Center, Seoul National University Bundang Hospital
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Park Seung-Jung
Cardiovascular Center and Department of Internal Medicine, Seoul National University Hospital
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Kim Kyung-Hee
Cardiovascular Center and Department of Internal Medicine, Seoul National University Hospital
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Oh Il-Young
Cardiovascular Center and Department of Internal Medicine, Seoul National University Hospital
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Park Kyung-Il
Cardiovascular Center and Department of Internal Medicine, Seoul National University Hospital
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Seo Myung-Ki
Cardiovascular Center and Department of Internal Medicine, Seoul National University Hospital
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Chung Jin-Wook
Cardiovascular Center and Department of Internal Medicine, Seoul National University Hospital
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Park Kyung
Cardiovascular Center and Department of Internal Medicine, Seoul National University Hospital
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Lee Hae-Young
Cardiovascular Center and Department of Internal Medicine, Seoul National University Hospital
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