Abstract 13697: The Optimal Strategy for In-stent Restenosis at the Right Coronary Artery Ostial Lesion After Stent Implantation
Background: Drug-eluting stent (DES) has markedly reduced the incidence of in-stent restenosis (ISR); however, the incidence of ISR is still high. Thus, we investigated the optimal percutaneous coronary intervention (PCI) strategy for ISR by comparing the results of PCI with plain old balloon angioplasty, drug-eluting balloon, 1st generation DES (sirolimus-eluting stent, biolimus-eluting stent) and new generation DES (everolimus-eluting stent, biolimus-eluting stent) for ISR at the RCA ostial lesion.
Method: An ostial lesion was defined as a lesion within 5 mm from the ostium. From May 1997 to September 2012, 383 de novo lesions at the ostium were treated by PCI. Of these, 258 lesions were angiographically followed after 6 to 8 months (midterm f/u). The restenosis rate was 38.0% (98/258) and the target lesion revascularization (TLR) rate was 27.5% (71/258). PCI was performed in 231 ISR lesions at the RCA ostium, of which 202 lesions were angiographically followed at midterm. ISR which occurred at the ostium after ostial stenting without stenosis at the ostium was included in our candidates.
Results: The data are shown in the table. At midterm f/u, the rates of re-restenosis and re-TLR were significantly higher after plain old balloon angioplasty than other strategies. The restenosis rate of new generation DES was significantly lower than other strategies.
Conclusions: New generation DES could be a preferable treatment modality for ISR at the RCA ostial lesion.
- © 2013 by American Heart Association, Inc.