Contribution of Stent Underexpansion to Recurrence After Sirolimus-Eluting Stent Implantation for In-Stent Restenosis

Fujii, Kenichi; Mintz, Gary S.; Kobayashi, Yoshio; Carlier, Stéphane; Takebayashi, Hideo; Yasuda, Takenori; Moussa, Issam; Dangas, George; Mehran, Roxana; Lansky, Alexandra J.; Reyes, Arlene; Kreps, Edward M.; Collins, Michael J.; Colombo, Antonio; Stone, Gregg W.; Teirstein, Paul S.; Leon, Martin B.; Moses, Jeffrey W.

doi:10.1161/01.cir.0000121327.67756.19

Cited by 275 publications

(159 citation statements)

References 14 publications

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“…Postdilatation using a high-pressure balloon is known as the standard deployment technique of contemporary metallic stents because the risk of TVR and ST is related to the final stent dimensions as guided by IVUS [31,32]. Metallic stents have a stable structure that is able to provide reliable and compliant expansion of the struts without the risk of disruption; however, BRS with polymeric materials has raised concerns www.cardiologyjournal.org regarding over-expansion, disruption, and the effect of postdilatation following its implantation [27,33].…”

Section: Discussionmentioning

confidence: 99%

Impact of postdilatation on performance of bioresorbable vascular scaffolds in patients with acute coronary syndrome compared with everolimus-eluting stents: A propensity score-matched analysis from a multicenter “real-world” registry

et al. 2016

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Background: Safety and efficacy of bioresorbable vascular scaffolds (BRS) and the role of postdilatation on outcome in acute coronary syndrome (ACS) patients compared with those of everolimus-eluting stents (EES) remain unknown. The aim of the study is to compare the safety and efficacy of BRS with EES in ACS and without, comparable to EES patients (6.0% vs. 12.6% vs. 4.7%, p < 0.001). The same trend was observed for TLR (3.4% vs. 8.4% vs. 1.9%, p < 0.001 (Cardiol J 2016; 23, 4: 374-383)

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Section: Discussionmentioning

confidence: 99%

Impact of postdilatation on performance of bioresorbable vascular scaffolds in patients with acute coronary syndrome compared with everolimus-eluting stents: A propensity score-matched analysis from a multicenter “real-world” registry

et al. 2016

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“…Several factors determine an inhomogeneous drug distribution promoting the ISR process: vessel and lesion characteristics (a tortuous segment, a calcified vessel, a different caliber of the vessel segment or bifurcation lesions), possible stent struts fractures and finally stent underexpansion (33).…”

Section: Lesion and Procedural-related Factorsmentioning

confidence: 99%

Understanding and managing in-stent restenosis: a review of clinical data, from pathogenesis to treatment

et al. 2016

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“…40 Coronary calcification may cause DES underexpansion, which is a risk for restenosis after PCI, even with DES. 41 Damage to the polymer of the DES might occur while it is being delivered through a calcified coronary artery in dialysis patients. 42,43 The inhibitory effects of sirolimus on neointimal growth in dialysis patients may be insufficient to prevent restenosis.…”

Section: Pathogenesismentioning

confidence: 99%

Use of Drug-Eluting Stents in Patients With Coronary Artery Disease and Renal Insufficiency

El‐Menyar

Suwaidi

Holmes

2010

Mayo Clinic Proceedings

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Renal insufficiency (RI) has been shown to be associated with increased major adverse cardiovascular events after percutaneous coronary intervention. We reviewed the impact of RI on the pathogenesis of coronary artery disease and outcomes after percutaneous coronary intervention in the form of drug-eluting stent (DES) implantation in these high-risk patients. We searched the English-language literature indexed in MEDLINE, Scopus, and EBS-CO Host research databases from 1990 through January 2009, using as search terms coronary revascularization, drug-eluting stent, and renal insufficiency. Studies that assessed DES implantation in patients with various degrees of RI were selected for review. Most of the available data were extracted from observational studies, and data from randomized trials formed the basis of a post hoc analysis. The outcomes after coronary revascularization were less favorable in patients with RI than in those with normal renal function. In patients with RI, DES implantation yielded better outcomes than did use of bare-metal stents. Randomized trials are needed to define optimal treatment of these high-risk patients with coronary artery disease. © 2010 Mayo Foundation for Medical Education and ResearchR enal insufficiency (RI), defined as creatinine clearance lower than or equal to 60 mL/min, is prevalent in patients with coronary artery disease (CAD). [1][2][3][4][5] In patients with acute coronary syndrome undergoing percutaneous coronary intervention (PCI), even mild RI is an independent predictor of worse outcomes.1 Renal insufficiency is a potent risk factor for CAD and qualifies as a coronary risk equivalent. Chronic RI not only increases cardiovascular event risk but also is associated with worse outcomes if an event occurs. 6 Diagnostic coronary angiography and PCI are used less frequently in patients with reduced renal function; risk of complications from these procedures is increased in the presence of RI. 7,8 This increased risk has been shown to occur at even moderate levels of RI, despite the use of advanced stent technology and optimal adjunctive medical therapy. Best et al 10 reported an RI prevalence of 49.1% in patients undergoing elective PCI. In that study, RI had a negative impact similar to that of diabetes mellitus (DM) on cardiovascular outcomes.10 One year after PCI, chronic RI was associated with a doubling of mortality in patients with mild RI, a 5-fold increase in patients with moderate RI, and a 12-fold increase in patients with severe RI. 10 In primary PCI for myocardial infarction (MI), a notable incremental reduction in survival was evident for each decline of 10 mL/min in creatinine clearance.11 Unfortunately, most randomized trials of patients undergoing PCI have excluded patients with severe RI. 12,13 This narrative review aims to identify the impact of a drug-eluting stent (DES) in the performance of PCI in patients with RI. METHODSWe evaluated the impact of RI on the pathogenesis of CAD and outcomes after PCI (in the form of DES implantation) in these high...

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Contribution of Stent Underexpansion to Recurrence After Sirolimus-Eluting Stent Implantation for In-Stent Restenosis

Cited by 275 publications

References 14 publications

Impact of postdilatation on performance of bioresorbable vascular scaffolds in patients with acute coronary syndrome compared with everolimus-eluting stents: A propensity score-matched analysis from a multicenter “real-world” registry

Impact of postdilatation on performance of bioresorbable vascular scaffolds in patients with acute coronary syndrome compared with everolimus-eluting stents: A propensity score-matched analysis from a multicenter “real-world” registry

Understanding and managing in-stent restenosis: a review of clinical data, from pathogenesis to treatment

Use of Drug-Eluting Stents in Patients With Coronary Artery Disease and Renal Insufficiency

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