medigraphic.com
ISSN 1561-2937 (Print)

2015, Number 1

<< Back Next >>

Rev Cubana Cardiol Cir Cardiovasc 2015; 21 (1)

Associated factors to the recurrence of the intrastent stenosis coronary conventional

Leyva QAY, León GM, Valdés RMA, Ponte GG, Mendoza OJL, Rodríguez BS

Language: Spanish
References: 28
Page: 9-15
PDF size: 339.05 Kb.


ABSTRACT

Stent restenosis is the main medium and long term limitation of percutaneous coronary intervention with stent. With the objective of characterizing the clinical, angiographic and therapeutic contexts of patients with this complication, a descriptive, retrospective and transverse study was carried out in “Hermanos Ameijeiras” Teaching Hospital with 166 patients with restenosis after bare metal stent implant between January 2006 and December 2010. To determine variables associated with recidivantrestenotic tendency, a univariate and multivariate (logistic regression) analysis was carried out. 69.3% were men, 101(60.8%) had stable angina, 44% had diffuse restenosis and the left anterior descending artery was the afected vessel in 92 patients. 130 patients were treated with coronary angioplasty, in 54.2% bare metal stents were deployed and the angiographic success rate was 97.7%. Recidivance ocurred in 25.3% of the cases. The diffuse morphological pattern was the only variable associated independently to recurrent intrastent restenosis.


REFERENCES

  1. Kortsarz LA, Saravia TS, Otero O, Sanchez JA, Solá MV. Reestenosis “muy tardía”, sintomática, de un stent coronario. Rev. Argentina de cardiología 2007; 75:487-489.

  2. Kibos A, Campeanu A, Tintoiu I. Pathophysiology of coro-nary artery in-stent restenosis. Acute Card Care. 2007; 9 (2):111-9.

  3. Jukema JW, Verschuren JW, Ahmed TA N, Quax PH A. Restenosis after PCI.Part I: Pathophysiology and risk fac-tors.Nat. Rev. Cardiol.2012; 9: 53–62

  4. PascualFigal DA, Valdés Chavarri M, PicóAracil F, Pinar Bermúdez E, IñigoGarcía L, LópezPalop R et al. Utilidad de los predictores de reestenosisangiográfica en la predicción de reestenosis clínica de stentsintracoronarios. RevEspCardiol. 2000; 53: 1183-1188.

  5. Gabay J. Stent liberador de droga: ¿una alternativa terapéuti-ca válida para la reestenosisintrastent?.Revista Argentina de Cardiología. 2009; 77(6).

  6. Byrne R, Lijima R, Mehilli J, Pache J,Schulz S, Schömig A et al. Tratamiento de la reestenosis de stents liberadores de paclitaxel mediante implantación de stents liberadores de si-rolimus. Resultados angiográficos y clínicos. RevEspCardiol. 2008; 61:1134-9.

  7. Bauters C, Hubert E, Prat A, Bougrimi K, Van Belle E, McFadden EP et al. Predictors of restenosis after coronary stent implantation. J Am CollCardiol 1998; 31: 1291-1298.

  8. Morales FJ, Romero P, Lozano J, Oneto J, López M, Martí-nez M et al. El comportamiento reestenótico previo como predictor pronóstico ante nueva implantación de stent con-vencional en distinta localización. RevEspCardiol. 2007;60(4):384-91

  9. Zueco Gil J. Importancia de los factores clínicos y anatómi-cos en el intervencionismo coronario. RevEspCardiol 2005; 58(4):430-41.

  10. Kimura T, Abe K, Shizuta S, Odashiro K. Long-term clinical and angiographic follow-up after coronary stent placement in native coronary arteries.Circulation 2002; 105:2986-2991.

  11. Sasao H, Ogata H, Hotta D. Clinical and angiographic out-comes after Multi-Link PENTA stent implantation in japa-nese patients with coronary artery disease. Intern Heart J. 2005; 46:997-1006.

  12. Batyraliev TA, Samko AN, Pershukov IV. Clinical and angi-ographical results of the use of the EPHESOS stent in pa-tients with coronary artery atherosclerosis. Kardiologia.2002; 42(2):4-7

  13. Mandeep S. Clinical and angiographic predictors of resteno-sis after percutaneous coronary intervention. Insights from the prevention of restenosis with tranilast and its outcomes (PRESTO) Trial. Circulation. 2004; 109:2727-2731.

  14. Marso SP, Giorgi LV, Johnson Wl, Huber KC, Laster SB, Shelton CJ et al. Diabetes mellitus is associated with a shift in the temporal risk profile of in-hospital death after percuta-neous coronary interventions: an analysis of 25,223 patients over 20 years. Am Heart J. 2003; 145:270-7.

  15. Rozeman Y, Sapoznikov D, Gotsman MS. Restenosis and progression of coronary disease after balloon angioplasty in patients with diabetes mellitus. ClinCardiol. 2000; 23:890-4.

  16. Barsness GW, Hardison RM, Detre MK, Alderman EL, Bou-rassa MG, Bashore TM, et al. Lesion progression and reeste-nosis in PTCA-treated diabetic and non-diabetic patients with multivessel disease. Circulation 2000; 102 (Suppl II):479.

  17. Rihal CH, Raco D, Gersh B, Yusuf S. Indications for coro-nary artery bypass surgery and percutaneous coronary inter-vention in chronic stable angina. Circulation. 2003; 108:2439-45.

  18. Aroche R, Obregón AG, Conde H, Hernández M, Calderón W, Rodríguez A. Reestenosis post implante de stentcoronario metálico convencional. Centro de Investigaciones Médico Quirúrgicas. 2007; 2(10).

  19. Italia Goldberg SL, Loussararian A, De Gregorio J, Di Mario C, Albiero R, Colombo A. Predictorsofdiffuseandaggressiveintrastentrestenosis. J Am CollCardiol 2001; 37(4):1019-25),

  20. Lee SG, Lee CW, Hong MK, Park HK, Kim JJ, Park SW, et al. Predictors of diffuse-type in-stent restenosis after coro-nary stent implantation. Catheter CardiovascInterv 1999; 47(4):406- 410.

  21. Silber S, Albertsson P, Aviles FF, Camici PG, Colombo A, Hamm C, Jorgensen E, Marco J, Nordrehaug JE, Ruzyllo W, Urban P, Stone GW, Wijns W. Guidelines for percutaneous-coronaryinterventions. The Task Force for Percutaneous Co-ronary Interventions of the European Society of Cardiology. EurHeart J. 2005;26:804-47.

  22. Alfonso F, Zueco J, Cequier A, Mantilla R, Bethencourt A, López- Mínguez JR, et al. Restenosis Intra-stent: Balloon Angioplasty Versus Elective Stenting (RIBS) Investigators. A randomized comparison of repeat stenting with ballon an-gioplasty in patients with in-stent restenosis. J Am CollCar-diol. 2003:42:796-805.

  23. Leguizamónmtsac J, FSCAI, FACC, Schipani G, Chambre D, Azzari F, Andersen G, Fernandez A, Romero G, Nauwerkmt-sac R, Torresani E, FSCAI, Martino G. Stents liberadores de droga eneltratamiento de lareestenosisintrastent difusa: pre-dictores clínicos y angiográficos de eventos. Revista Argen-tina de Cardiología / vol 77 Nº 6 / Noviembre - Diciembre 2009.

  24. Albertal M, Cura F, Padilla LT, Thierer J, Botto F, Trivi M, et al. Uso de stentliberador de droga para el tratamiento de la reestenosisintrastent en la práctica diaria. Resultados de un centro de alto volumen en la Argentina. Rev Argent Cardiol 2007;75:243-8.

  25. Bauters C, Banos JL, Van Belle E, Mc Fadden EP, Lablanche JM, Bertrand ME. Six-month angiographic outcome after successful repeat percutaneous intervention for in-stent reste-nosis. Circulation 1998; 97: 318-321.

  26. Eltchaninoff H, Koning R, Tron C, Gupta V, Cribier A. Bal-loon angioplasty for the treatment of coronary in-stent reste-nosis: immediate results and 6-month angiographic recurrent restenosis rate. J Am Coll 1998; 32: 980-984.

  27. Alfonso F. Long-term clinical benefit of sirolimus-eluting stents in patients with in-stent restenosis results of the RIBS-II (Restenosis Intra-stent: Balloon angioplasty vs. elective si-rolimus-eluting Stenting) study. J.Am. Coll. Cardiol. 52, 1621–1627 (2008).

  28. Habara S, Mitsudo K, Goto T, Kadota K, Fujii S, Yamamoto H, et al. The impact of lesion length and vessel size on out-comes after sirolimus-eluting stent implantation for in-stent restenosis. Heart 2008; 94:1162-5




2020     |     www.medigraphic.com