TY - JOUR
T1 - First clinical experience with a paclitaxel derivate-eluting polymer stent system implantation for in-stent restenosis
T2 - Immediate and long-term clinical and angiographic outcome
AU - Liistro, Francesco
AU - Stankovic, Goran
AU - Di Mario, Carlo
AU - Takagi, Takuro
AU - Chieffo, Alaide
AU - Moshiri, Shahram
AU - Montorfano, Matteo
AU - Carlino, Mauro
AU - Briguori, Carlo
AU - Pagnotta, Paolo
AU - Albiero, Remo
AU - Corvaja, Nicola
AU - Colombo, Antonio
PY - 2002/4/23
Y1 - 2002/4/23
N2 - Background - It has been shown that antiproliferative drugs such as paclitaxel lower the amount of intimal hyperplasia after stent implantation. We report the first clinical experience of 7-hexanoyltaxol (QP2)-eluting polymer stent system (QuaDS) implantation for in-stent restenosis. Methods and Results - Fifteen consecutive patients with elective indication to percutaneous coronary intervention for in-stent restenosis were treated with the QuaDS-QP2 stent implantation. The QuaDS-QP2 stent was successfully implanted in all but 2 target lesions. In one lesion, the restenotic segment could not be completely covered by the stent, and in another lesion, a bare metal stent was implanted distally to the QuaDS-QP2 stent. One patient suffered from postprocedural non-Q-wave myocardial infarction (NQWMI). No other adverse events were observed during hospital stay. Six- and 12-month angiographic and clinical follow-up was scheduled for all patients. At 6 months, 3 patients had target lesion revascularization (20%). Two patients had restenosis (13.3%); one experienced restenosis in a gap between 2 drug-eluting stents, and the other had stent occlusion leading to NQWMI. Minimal intimal hyperplasia was observed in all the segments covered by drug-eluting stents (late loss=0.47±1.01 mm with a loss index=0.17±0.39). At 12 months, 1 patient suffered from NQWMI, and 8 of 13 patients (61.5%) had angiographic restenosis (late loss= 1.36±O.94 mm with a loss index= 0.62±0.44). Conclusion - This first experience with QuaDS-QP2 stent implantation for in-stent restenosis revealed minimal intimal hyperplasia at the 6-month follow-up. However, the antiproliferative effect was not maintained at the 12-month follow-up, resulting in delayed occurrence of angiographic restenosis.
AB - Background - It has been shown that antiproliferative drugs such as paclitaxel lower the amount of intimal hyperplasia after stent implantation. We report the first clinical experience of 7-hexanoyltaxol (QP2)-eluting polymer stent system (QuaDS) implantation for in-stent restenosis. Methods and Results - Fifteen consecutive patients with elective indication to percutaneous coronary intervention for in-stent restenosis were treated with the QuaDS-QP2 stent implantation. The QuaDS-QP2 stent was successfully implanted in all but 2 target lesions. In one lesion, the restenotic segment could not be completely covered by the stent, and in another lesion, a bare metal stent was implanted distally to the QuaDS-QP2 stent. One patient suffered from postprocedural non-Q-wave myocardial infarction (NQWMI). No other adverse events were observed during hospital stay. Six- and 12-month angiographic and clinical follow-up was scheduled for all patients. At 6 months, 3 patients had target lesion revascularization (20%). Two patients had restenosis (13.3%); one experienced restenosis in a gap between 2 drug-eluting stents, and the other had stent occlusion leading to NQWMI. Minimal intimal hyperplasia was observed in all the segments covered by drug-eluting stents (late loss=0.47±1.01 mm with a loss index=0.17±0.39). At 12 months, 1 patient suffered from NQWMI, and 8 of 13 patients (61.5%) had angiographic restenosis (late loss= 1.36±O.94 mm with a loss index= 0.62±0.44). Conclusion - This first experience with QuaDS-QP2 stent implantation for in-stent restenosis revealed minimal intimal hyperplasia at the 6-month follow-up. However, the antiproliferative effect was not maintained at the 12-month follow-up, resulting in delayed occurrence of angiographic restenosis.
KW - Angiography
KW - Restenosis
KW - Stents
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U2 - 10.1161/01.CIR.0000016042.69606.61
DO - 10.1161/01.CIR.0000016042.69606.61
M3 - Article
C2 - 11997271
AN - SCOPUS:0037161356
VL - 105
SP - 1883
EP - 1886
JO - Circulation
JF - Circulation
SN - 0009-7322
IS - 16
ER -