Park Chang-Bum, Hong Myeong-ki, Kim Young-Hak, Park Duk-Woo, Han Ki-Hoon, Lee Cheol Whan, Kang Duck-Hyun, Song Jae-Kwan, Kim Jae-Joong, Park Seong-Wook, Park Seung-Jung
Department of Internal Medicine, Seoul Veterans Hospital, Seoul, South Korea.
Int J Cardiol. 2007 Sep 3;120(3):387-90. doi: 10.1016/j.ijcard.2006.10.014. Epub 2007 Feb 8.
Angiographic pattern of in-stent restenosis (ISR) after drug-eluting stent (DES) implantation was known to be different to that after bare metal stent (BMS) implantation. But the different angiographic patterns of ISR and its prognosis between sirolimus-eluting stent (SES) and paclitaxel-eluting stent (PES) has not been properly addressed in large scale studies.
We evaluated the angiographic pattern of ISR and their subsequent clinical outcomes in 177 ISR lesions of 163 consecutive patients previously treated with SES (n=97) or PES (n=80) from February 2003 to April 2005.
In angiographic ISR pattern, diffuse ISR was more common in PES implantation (SES vs PES; 23.7% vs 48.7%, p=0.001) mainly because of higher incidence of diffuse intrastent ISR (8.2% vs 33.8%, p<0.001, respectively) whereas focal ISR was more common in SES implantation (76.3% vs 51.3%, p=0.001, respectively) mainly because of higher incidence of focal margin ISR (27.8% vs 2.5%, p<0.001, respectively). Among 177 ISR lesions, clinically driven target lesion revascularization (TLR) was performed in 53.6% in SES implantation and 56.3% in PES implantation (p=0.725).
Angiographic pattern of ISR differed after SES and PES implantation, but their subsequent TLR rate was similar to both types of DES.
已知药物洗脱支架（DES）植入后支架内再狭窄（ISR）的血管造影模式与裸金属支架（BMS）植入后不同。但西罗莫司洗脱支架（SES）和紫杉醇洗脱支架（PES）之间ISR不同的血管造影模式及其预后在大规模研究中尚未得到妥善解决。
我们评估了2003年2月至2005年4月期间163例连续患者的177个ISR病变的ISR血管造影模式及其随后的临床结果，这些患者先前接受过SES（n = 97）或PES（n = 80）治疗。
在血管造影ISR模式中，弥漫性ISR在PES植入中更常见（SES与PES；23.7%对48.7%，p = 0.001），主要是因为弥漫性支架内ISR的发生率更高（分别为8.2%对33.8%，p < 0.001），而局灶性ISR在SES植入中更常见（分别为76.3%对51.3%，p = 0.001），主要是因为局灶性边缘ISR的发生率更高（分别为27.8%对2.5%，p <
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