1. Early- and Medium-Term Outcomes After Paclitaxel-Eluting Stent Implantation for Sirolimus-Eluting Stent Failure
- Author
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Lee, Steve S., Price, Matthew J., Wong, Garrett B., Valencia, Rafael, Damani, Samir, Sawhney, Neil, Gollapudi, Raghava R., Schatz, Richard A., and Teirstein, Paul S.
- Subjects
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MEDICAL records , *MYOCARDIAL revascularization , *ANTINEOPLASTIC agents , *MYOCARDIAL infarction - Abstract
The optimal treatment for sirolimus-eluting stent (SES) restenosis is not known. This study evaluated the safety and clinical outcome of paclitaxel-eluting stent (PES) implantation for SES restenosis. From March 2004 to July 2005, PESs were implanted in 125 patients with 140 lesions with SES restenosis. Acute and 6-month clinical outcomes were determined through review of the medical record and/or telephone interview. In-hospital major adverse cardiac events (death, nonfatal myocardial infarction, or repeat revascularization) occurred in 14 patients (11.2%), driven entirely by postprocedure non–Q-wave myocardial infarction. At a mean clinical follow-up of 7.2 ± 1.8 months, the incidence of target lesion revascularization (TLR) was 14.0%, and the rate of major adverse cardiac events was 17.2%. Subacute thrombosis occurred in 2 patients (1.6%). Length of PES implanted, postprocedure diameter stenosis, and total occlusion of the target lesion were independent predictors of TLR. In patients with de novo SES restenosis, TLR was only 8.7%. In conclusion, at medium-term follow-up, PES implantation for SES failure appears to be safe and effective, although efficacy is decreased in the setting of total occlusions, greater residual diameter stenosis, and longer PESs. [Copyright &y& Elsevier]
- Published
- 2006
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