Early- and Medium-Term Outcomes After Paclitaxel-Eluting Stent Implantation for Sirolimus-Eluting Stent Failure

Steve S. Lee, Matthew J. Price, Garrett B Wong, Rafael Valencia, Samir Damani, Neil Sawhney, Raghava R. Gollapudi, Richard A. Schatz, Paul S. Teirstein

Research output: Contribution to journalArticle

31 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1345-1348
Number of pages4
JournalAmerican Journal of Cardiology
Volume98
Issue number10
DOIs
StatePublished - Nov 15 2006
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Lee, S. S., Price, M. J., Wong, G. B., Valencia, R., Damani, S., Sawhney, N., Gollapudi, R. R., Schatz, R. A., & Teirstein, P. S. (2006). Early- and Medium-Term Outcomes After Paclitaxel-Eluting Stent Implantation for Sirolimus-Eluting Stent Failure. American Journal of Cardiology, 98(10), 1345-1348. https://doi.org/10.1016/j.amjcard.2006.07.023