Abstract 3032: Repeated Target Lesion Revascularization in Patients Treated with Sirolimus-Eluting Stent or Balloon Angioplasty for Post-Sirolimus-Eluting Stent Restenosis: Insights from j-CYPHER Registry
Background: Although sirolimus-eluting stents (SESs) are proven as an effective treatment for bare metal stent restenosis, there are few studies comparing SES implantation with balloon angioplasty (BA) for the treatment of post-SES restenosis.
Methods: Design of j-CYPHER registry was multi-center prospective enrollment of consecutive patients receiving SES implantation from 37 centers in Japan. From August 2004 to November 2006, 12812 patients with 17545 lesions were implanted with SES. Among them, we identified 513 post-SES restenosis treated with SES (n = 228) or BA (n = 285) at their operators’ discretion and followed for 1 year.
Results: Baseline clinical and angiographic characteristics were well matched except that patients receiving SES had more peripheral vascular disease (p = 0.02) and saphenous vein graft lesions (p = 0.03), and that patients treated with BA had greater diabetes mellitus (p = 0.01) and in-stent restenosis at index procedure (p = 0.006). Repeated target lesion revascularization (TLR) within 1 year occurred in 25.4% (58/228) of SES-treated lesions and 48.8% (139/285) of BA-treated lesions. After adjustment for all risk factors identified by univariate analysis (p < 0.20), multivariate logistic regression model showed that an additional SES-implantation (vs. BA) [odds ratio: 0.28, 95% confidence interval: 0.18 – 0.43] was independently associated with low repeated TLR rate of post-SES restenosis (Table⇓).
Conclusions: Repeated TLR within 1 year occurred in 25.4% of SES-treated lesions and 48.8% of BA-treated lesions. After adjustment, an additional SES-implantation is superior to BA for the treatment of post-SES restenosis in our study population.