Six-month clinical and angiographic outcome after successful excimer laser angioplasty for in-stent restenosis

TY - JOUR

T1 - Six-month clinical and angiographic outcome after successful excimer laser angioplasty for in-stent restenosis

AU - Köster, Ralf

AU - Kähler, Jan

AU - Terres, Wolfram

AU - Reimers, Jacobus

AU - Baldus, Stephan

AU - Hartig, Dirk

AU - Berger, Jürgen

AU - Meinertz, Thomas

AU - Hamm, Christian W.

N1 - Funding Information: This work was supported, in part, by a grant from Spectranetics B.V. (Leusden, the Netherlands).

PY - 2000/7

Y1 - 2000/7

N2 - Objectives. This study evaluated the clinical and angiographic six-month follow-up after excimer laser coronary angioplasty (ELCA) for restenosed coronary stents. Background. Excimer laser coronary angioplasty has recently been shown to be safe and efficient for the treatment of in-stent restenosis. Methods. Ninety-six consecutive patients successfully treated with ELCA within 141 stents were included in a six-month clinical and angiographic follow-up. Results. During follow-up there was one sudden death and one patient with documented myocardial infarction. Angina pectoris classified as ≥ Canadian Cardiovascular Society II reoccurred in 49 patients. Follow-up angiography was obtained in 89 patients (93%) with 133 stents. Quantitative coronary angiography revealed a mean diameter stenosis of 77 ± 10% before intervention, 41 ± 12% after laser treatment and 11% ± 12% after adjunctive percutaneous transluminal coronary angioplasty (p < 0.001). Six months after ELCA the mean diameter stenosis had increased to 60 ± 26% (p < 0.001). A ≥50% diameter stenosis was present in 48 patients (54%); in 24 of these patients diameter stenosis was ≥70%. Total occlusions occurred in an additional 10 patients (11%). There was a trend toward an increased recurrent restenosis rate in patients with diabetes mellitus and long lesions or total occlusions (p = 0.059). Forty-eight patients (50%) received medical treatment after six months. Reinterventions were necessary in 30 patients (31%), and coronary artery bypass surgery was performed in 17 patients (18%). Event-free survival was 50%. Conclusions. Excimer laser angioplasty for in-stent restenosis was associated with a high incidence of recurrent restenosis in this group of patients, suggesting that this technique is unlikely to reduce recurrent in-stent restenosis and that other approaches are necessary. (C) 2000 by the American College of Cardiology.

AB - Objectives. This study evaluated the clinical and angiographic six-month follow-up after excimer laser coronary angioplasty (ELCA) for restenosed coronary stents. Background. Excimer laser coronary angioplasty has recently been shown to be safe and efficient for the treatment of in-stent restenosis. Methods. Ninety-six consecutive patients successfully treated with ELCA within 141 stents were included in a six-month clinical and angiographic follow-up. Results. During follow-up there was one sudden death and one patient with documented myocardial infarction. Angina pectoris classified as ≥ Canadian Cardiovascular Society II reoccurred in 49 patients. Follow-up angiography was obtained in 89 patients (93%) with 133 stents. Quantitative coronary angiography revealed a mean diameter stenosis of 77 ± 10% before intervention, 41 ± 12% after laser treatment and 11% ± 12% after adjunctive percutaneous transluminal coronary angioplasty (p < 0.001). Six months after ELCA the mean diameter stenosis had increased to 60 ± 26% (p < 0.001). A ≥50% diameter stenosis was present in 48 patients (54%); in 24 of these patients diameter stenosis was ≥70%. Total occlusions occurred in an additional 10 patients (11%). There was a trend toward an increased recurrent restenosis rate in patients with diabetes mellitus and long lesions or total occlusions (p = 0.059). Forty-eight patients (50%) received medical treatment after six months. Reinterventions were necessary in 30 patients (31%), and coronary artery bypass surgery was performed in 17 patients (18%). Event-free survival was 50%. Conclusions. Excimer laser angioplasty for in-stent restenosis was associated with a high incidence of recurrent restenosis in this group of patients, suggesting that this technique is unlikely to reduce recurrent in-stent restenosis and that other approaches are necessary. (C) 2000 by the American College of Cardiology.

UR - http://www.scopus.com/inward/record.url?scp=17444438291&partnerID=8YFLogxK

U2 - 10.1016/S0735-1097(00)00704-X

DO - 10.1016/S0735-1097(00)00704-X

M3 - SCORING: Journal article

C2 - 10898415

AN - SCOPUS:17444438291

VL - 36

SP - 69

EP - 74

JO - J AM COLL CARDIOL

JF - J AM COLL CARDIOL

SN - 0735-1097

IS - 1

ER -