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...
DARE: Drug-Coated Balloons Compete with DES for the Treatment of In-Stent Restenosis
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...
Success in CTOs caused by restenosis lowers cardiac mortality
Courtesy of Dr. Carlos Fava. Nowadays, chronic total occlusions (CTO) due to in-stent restenosis (ISR) represent 5%-25% of all coronary angioplasties. These lesions pose a new and true challenge, since CTOs are often associated with stent-related problems (fractures, lack of expansion, overlapping, deformation), extreme tortuosity, severe calcification, tandem lesions after CTO, and aorto-ostial lesions, with little...
Edge Restenosis with Everolimus Eluting Stents: a few Predictors
Stent edge restenosis continues to be a weakness of drug eluting stents (DES). The aim of this study was to determine its predictors using optical coherence tomography (OCT). The study retrospectively analyzed 319 patients receiving OCT immediately after everolimus eluting stent implantation (EES) looking into the immediate outcome, and follow up angiography at 9...
Predictors of Restenosis and Stroke Following Carotid PCI
Original Title: Predictors of Restenosis Following Carotid Angioplasty and Stenting. Reference: Elena Zapata-Arriaza et al. Stroke. 2016 Jun 21. Epub ahead of print. Restenosis after carotid PCI is associated to an increase of stroke and death risk. The purpose of this study was to determine the risk and predicting factors associated to carotid restenosis...
Instent restenosis: Drug eluting balloons or drug eluting stents?
Original Title: Long-Term Results of Everolimus-Eluting Stents versus Drug-Eluting Balloons in Patients with Bare-Metal In-Stent Restenosis 3-Year Follow-Up of the RIBS V Clinical Trial. Reference: Alfonso F. et al. JACC Cardiovasc Interv. 2016 Jun 27;9(12):1246-55. Courtesy of Dr. Agustín Vecchia. RIBS V 3 year follow up Stents have become the gold standard for...
In Stent Restenosis: Diagnosis and Therapy
Juan F. Granada2014-04-22 Executive Director and Chief Scientific OfficerSkirball Research CenterCardiovascular Research FoundationColumbia University Medical Center, New York
EXCITE ISR: Excimer laser versus balloon angioplasty for stent restenosis of the superficial femoral
This multicenter, prospective, randomized trial compared the Excimer laser atherectomy (Excimer Laser Atherectomy = ELA, Spectranetics, Inc.) with a balloon angioplasty in patients with in-stent restenosis in the superficial femoral artery. The injury was greater than 4 cm and the reference vessel diameter 5 to 7 mm. The mean lesion length was 19 cm, and...
RIBS IV: Drug-eluting balloon versus everolimus-eluting stent on in-stent restenosis
This prospective, multicenter, randomized trial compared the paclitaxel-eluting balloon versus everolimus-eluting stent to treat patients with in-stent restenosis. 309 patients were included in total (154 received the drug-eluting balloon, and 155 received the everolimus-eluting stent). There were no differences in the characteristics of both groups. At one year the rate of cardiac death, myocardial infarction...
ISAR-DESIRE 3: A paclitaxel eluting balloon versus Taxus in the treatment of eluting stent restenosis.
Fundamentals. Background: Although we’ve had more than a decade of experience with implanting drug-eluting stents, (DES), the best treatment for restenosis on these devices remains unknown. The drug-eluting balloons are a promising alternative which avoid the possibility of a new layer of metal on the restenotic injury. This study compared the performance of these balls...