AI Article Synopsis
- Despite advancements in stent technology, there's still a notable risk of in-stent restenosis (ISR) after procedures like PCI, and comprehensive data on this issue is limited.
- A study analyzed data from the France-PCI registry between 2014 and 2018, focusing on patients with ISR lesions, finding that 7.3% of the patients treated had ISR PCI, mostly involving older individuals with comorbidities like diabetes.
- The results revealed that those undergoing ISR PCI had higher rates of complications after one year compared to non-ISR patients, indicating a need for further research and improved techniques in managing ISR.
Article Abstract
Background: Despite the evolution of stent technology, there is a non-negligible risk of in-stent restenosis (ISR) after Percutaneous coronary intervention (PCI). Large-scale registry data on the prevalence and clinical management of ISR is lacking.
Methods: The aim was to describe the epidemiology and management of patients with ≥1 ISR lesions treated with PCI (ISR PCI). Data on characteristics, management and clinical outcomes were analyzed for patients undergoing ISR PCI in the France-PCI all-comers registry.
Results: Between January 2014 and December 2018, 31,892 lesions were treated in 22,592 patients, 7.3 % of whom underwent ISR PCI. Patients undergoing ISR PCI were older (68.5 vs 67.8; p < 0.001), and more likely to have diabetes (32.7 % vs 25.4 %, p < 0.001), chronic coronary syndrome or multivessel disease. ISR PCI concerned drug eluting stents (DES) ISR in 48.8 % of cases. Patients with ISR lesions were more frequently treated with DES than drug eluting balloon or balloon angioplasty (74.2 %, 11.6 % and 12.9 %, respectively). Intravascular imaging was rarely used. At 1 year, patients with ISR had higher target lesion revascularization rates (4.3 % vs. 1.6 %; HR 2.24 [1.64-3.06]; p < 0.001).
Conclusions: In a large all-comers registry, ISR PCI was not infrequent and associated with worse prognosis than non-ISR PCI. Further studies and technical improvements are warranted to improve the outcomes of ISR PCI.
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| http://dx.doi.org/10.1016/j.carrev.2023.02.006 | DOI Listing |
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