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  • Title: Contemporary treatment of in-stent restenosis and the incidence of recurrent in-stent restenosis in the era of drug-eluting stents.
    Author: Ajani AE, Yan BP, Clark DJ, Eccleston D, Walton A, Lew R, Meehan A, Brennan A, Reid C, Duffy SJ, Melbourne Interventional Group (MIG) Investigators.
    Journal: Heart Lung Circ; 2007 Aug; 16(4):269-73. PubMed ID: 17419097.
    Abstract:
    BACKGROUND: Optimal treatment of in-stent restenosis (ISR) remains uncertain in the era of drug-eluting stents (DES). This study aims to determine contemporary treatment of ISR and to assess recurrent ISR rates in the era of DES. METHODS: We examined 60 patients presenting for treatment of ISR (one lesion per patient) who were enrolled in the Melbourne Interventional Group Registry (4% of total population of 1423 patients) between April 2004 and January 2005. Twelve-month follow-up is complete for all patients. RESULTS: The majority of ISR treated occurred in bare metal stents [BMS (n=52, 87%)] and had a focal (<10 mm) pattern of ISR (53%). In-stent restenosis of DES occurred in eight (13%) patients. The majority of ISR were treated with additional stenting with a preference for DES over BMS in almost all cases. At 12 months, one patient died of non-cardiac cause and four patients (7%) presented with recurrent ISR. The incidence of recurrent ISR in DES was 5% (n=3). No late thrombosis was reported despite only 50% of patients having >or=12 months of clopidogrel therapy. CONCLUSIONS: Our study suggests drug-eluting stents are safe, effective and the preferred therapy for in-stent restenosis. The incidence of recurrent drug-eluting stent restenosis at 12 months is low.
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