Saia Francesco, Lemos Pedro A, Hoye Angela, Sianos Georgios, Arampatzis Chourmouzios A, de Feyter Pim J, van der Giessen Willem J, Smits Pieter C, van Domburg Ron T, Serruys Patrick W
Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands.
Catheter Cardiovasc Interv. 2004 Jul;62(3):283-8. doi: 10.1002/ccd.20068.
The purpose of this study was to compare the mid-term clinical outcome of sirolimus-eluting stent (SES) implantation and vascular brachytherapy (VBT) for in-stent restenosis (ISR). We assessed the 9-month occurrence of major adverse cardiac events (MACE) in 44 consecutive patients with ISR treated with SES implantation and 43 consecutive patients treated with VBT in the period immediately prior. Baseline clinical and angiographic characteristics of the two groups were similar. During follow-up, three patients (7%) died in the VBT group and none in the SES group. The incidence of myocardial infarction was 2.3% in both groups. Target lesion revascularization was performed in 11.6% of the VBT patients and 16.3% of the SES patients (P = NS). The 9-month MACE-free survival was similar in both groups (79.1% VBT vs. 81.5% SES; P = 0.8 by log rank). The result of this nonrandomized study suggests that sirolimus-eluting stent implantation is at least as effective as vascular brachytherapy in the treatment of in-stent restenosis.
本研究旨在比较西罗莫司洗脱支架（SES）植入术与血管内近距离放射治疗（VBT）治疗支架内再狭窄（ISR）的中期临床疗效。我们评估了44例接受SES植入术治疗的连续性ISR患者以及此前同期43例接受VBT治疗的连续性患者9个月时主要不良心脏事件（MACE）的发生情况。两组的基线临床和血管造影特征相似。随访期间，VBT组有3例患者（7%）死亡，SES组无死亡病例。两组心肌梗死发生率均为2.3%。VBT组11.6%的患者和SES组16.3%的患者接受了靶病变血管重建术（P = 无显著性差异）。两组9个月无MACE生存率相似（VBT组为79.1%，SES组为81.5%；对数秩检验P = 0.8）。这项非随机研究结果表明，在治疗支架内再狭窄方面，西罗莫司洗脱支架植入术至少与血管内近距离放射治疗效果相当。
