Treatment of Paclitaxel-Eluting Stent Restenosis With Sirolimus-Eluting Stent Implantation—Angiographic and Clinical Outcomes

Randomized Trial of Paclitaxel- Versus Sirolimus-Eluting Stents for Treatment of Coronary Restenosis in Sirolimus-Eluting Stents

“…Although concern has always existed regarding the advisability of the implantation of multiple stent layers in the same arterial segment, no evidence of any adverse safety signal was observed out to 12 months, with a rate of definite stent thrombosis of 0.4% for the study population as a whole. In terms of clinical efficacy, the overall rate of TLR at 12 months (approximately 15%) is remarkably consistent with that of earlier nonrandomized studies (3)(4)(5)(15)(16)(17) and was not different between the SES and PES treatment groups. This latter observation was mirrored in the comparative magnitude of late loss (SES 0.40 Ϯ 0.65 mm vs. PES 0.38 Ϯ 0.59 mm) between the 2 stent platforms and in keeping with the null hypothesis of the study (H 0 not rejected, p ϭ 0.85).…”

“…The predominantly focal See page 2717 pattern of restenosis (3)(4)(5) and the lessons learned from the management of bare metal stent restenosis-where DES therapy proved superior to balloon angioplasty and vascular brachytherapy (6-9)-makes treatment with repeat DES an attractive option. However, it remains to be determined whether implantation of DES eluting the same type of drug-a so-called "homo-DES" approach-is preferable to a switch to a DES eluting a different class of drug-a "hetero-DES" strategy.…”

Long-Term Outcomes After the Percutaneous Treatment of Drug-Eluting Stent Restenosis

“…The widespread use of DES and incorporation into daily practice has led to significant absolute numbers of patients presenting with DES failure (3). Although the optimal management strategy of DES in-stent restenosis (DES-ISR) remains unclear, repeat percutaneous intervention remains the most frequently used treatment (1,(3)(4)(5). However, the long-term angiographic and clinical outcomes after the percutaneous treatment of DES-ISR are unknown.…”

Drug eluting stent or drug eluting balloon? Which is the better device to treat instent restenosis?

“…Rozpowszechnienie DES skłoniło jednak do opracowania metod leczenia restenozy w ich obrębie. Wyniki przeprowadzonych badań [80][81][82] wskazują na korzyści wynikające ze wszczepienia w miejsce restenozy w DES stentu uwalniającego lek o innym mechanizmie działania. Jest to obecnie najczęściej stosowana metoda terapii zwę-żenia w DES.…”