Drug eluting stents (DES) have improved considerably over the years, reducing the initial indices of instent restenosis (ISR) by roughly 5-10% a year in USA. However, DES failure might lead to neointimal hyperplasia and neoatherosclerosis, which increases the chance of developing chronic and acute coronary syndromes. Drug coated balloons (DCB), which administer anti-proliferative agents with...
In stent restenosis (ISR) continues to be the main limitation to the percutaneous treatment of coronary artery disease, with 5 to 10% prevalence after new generation DES stenting. Guideline recommendations for this intervention include new DES stenting and the use of drug coated balloons (DCB). Recurrent ISR stenting rate ranges between 10 and 40%, and...
This was a prospective, multicenter, randomized study including 130 patients with instent restenosis treated with sirolimus coated balloons (DCB S) and 128 treated with paclitaxel coated balloons (DCB P). Primary end point was late lumen loss (LLL) at 12 months. There were no significant differences between the groups. Mean patient age was 63, 75% were...
Predictors of intrastent restenosis in the right coronary artery ostium. The ostium of the right coronary artery (RCA) presents certain histological aspects. Atherosclerotic and fibrotic plaques in this area contain an abundance of smooth muscle, collagen, and a certain degree of calcification, along with thicker adventitia. Additionally, it has certain anatomical aspects such as poor...
Score to predict the risk of repeat PCI in DES restenosis. With the use of drug eluting stents (DES) instent restenosis (ISR) has seen a significant reduction vs. bare metal stents (BMS) restenosis. The main cause of DES failure is ISR. This entity is difficult to manage because of its high recurrence and reintervention risk....
3 Year Clinical Outcome Analysis and Failure Predictors in the Use of Intracoronary Brachytherapy for Drug-Eluting Stent Restenosis In-stent restenosis (ISR) has been one of the greatest obstacles standing in the way of long term patency in percutaneous coronary interventions. However, the use of drug eluting stents (DES) and their development has helped reduce ISR...
The best strategy to treat in stent restenosis continues to be a dilemma. A new drug eluting stent (DES) seems to be the simplest treatment, even though it adds metal layers that will make it harder and harder to retreat. Drug coated balloons might be a viable alternative seeing as it seems to enable retreatment,...
The rationale behind the decision to not add another layer of metal to the artery sounded attractive and this was what paved the way for drug coated balloons as an alternative strategy to treat in-stent restenosis. “We’ve already got a stent in place, we only have to dilate and leave the drug” is what we...
Elective, uncomplicated repeat revascularization after stent restenosis is associated with higher mortality rates according to a new meta-analysis that will be published soon in J Am Coll Cardiol Intrv. Historically, interventional cardiologists have seen target lesion revascularization (TLR) as a procedure that “unjustly” increased combined events in clinical studies and our own databases, thus representing...
Courtesy of the Brazilian Society of Hemodynamics and Interventional Cardiology (SBHCI). The SeQuent Please paclitaxel-coated balloon provides non-inferior angiographic results when compared with the Xience everolimus-eluting stent for the treatment of in-stent restenosis. At 6 months, the minimal lumen diameter was 1.71 mm in the drug-coated balloon arm and 1.74 mm in the Xience arm, a difference that...