Late target lesion revascularization after implantation of sirolimus-eluting stent

Myeong Ki Hong, Gary S. Mintz, Whan Lee Cheol, Duk Woo Park, Seung Whan Lee, Young Hak Kim, In Hyun Jung, Sang Hyun Kim, Sang Sig Cheong, Jae Joong Kim, Seong Wook Park, Seung Jung Park

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Abstract

Objectives: We evaluated the incidence, clinical presentation, and angiographic in-stent restenosis (ISR) pattern of late target lesion revascularization (TLR) after sirolimus-eluting stent (SES) implantation. Background:〉 Late TLR is an unusual finding beyond 6-9 months after bare-metal stent implantation. However, late TLR after SES implantation has not been sufficiently evaluated. Methods: The study population consisted of 804 patients with 1,020 native lesions that were patent at 6-month follow-up angiogram after SES implantation. Results: Late TLR was performed in 18 patients with 18 lesions (1.8%) at 24.1 ± 2.6 months (range; 18-30 months) after SES implantation. Clinical presentation of late TLR patients was silent ischemia in eight patients and recurrent angina in 10 patients, but none had an acute coronary syndrome. Angiographic ISR pattern of late TLR lesions were focal ISR in 12 lesions (67%) and diffuse ISR in six lesions (33%). Serial quantitative coronary angiographic analysis of these lesions showed a minimal lumen diameter of 2.6 ± 0.5 mm immediately after SES implantation, 2.4 ± 0.4 mm at 6-month follow-up and 0.7 ± 0.6 mm at 24-month follow-up (ANOVA P < 0.001). By stepwise multiple logistic regression analysis, the only independent predictor of late TLR was stent length (P < 0.001, OR = 1.040, 95% CI = 1.019-1.061). Conclusions: Late TLR was performed in 1.8% of 1,020 native lesions that were patent at 6-month follow-up angiogram. Clinical presentations of late TLR was either silent ischemia or recurrent angina, but not acute coronary syndrome. Two-thirds of late TLR lesions had a focal angiographic ISR pattern.

Original languageEnglish
Pages (from-to)299-303
Number of pages5
JournalCatheterization and Cardiovascular Interventions
Volume71
Issue number3
DOIs
Publication statusPublished - 2008 Feb 5

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Hong, M. K., Mintz, G. S., Cheol, W. L., Park, D. W., Lee, S. W., Kim, Y. H., Jung, I. H., Kim, S. H., Cheong, S. S., Kim, J. J., Park, S. W., & Park, S. J. (2008). Late target lesion revascularization after implantation of sirolimus-eluting stent. Catheterization and Cardiovascular Interventions, 71(3), 299-303. https://doi.org/10.1002/ccd.21327