Clinical and angiographic follow-up after balloon angioplasty with provisional stenting for coronary in-stent restenosis

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Abstract
The objective of this study was to assess the angiographic and clinical outcome of patients with coronary in‐stent restenosis treated with balloon angioplasty with provisional stenting. The study included 375 consecutive patients with in‐stent restenosis managed with balloon angioplasty alone or combined with stenting. Clinical events were recorded during a 1‐year follow‐up period and quantitative analysis was performed on 6‐month angiographic data. Of the 373 patients (451 lesions) with a successful procedure, 273 were treated with angioplasty alone and 100 with additional stenting. Target lesion revascularization was required in 23.7% of the patients: 20.7% in patients with angioplasty and 31.0% in patients with stenting. Angiographic restenosis rate was 38.9%: 35.8% in the angioplasty group and 47.7% in the stent group. Stenting in small vessels was associated with a much higher restenosis rate than in larger vessels (65.6% vs. 37.5%, respectively; P = 0.01). Thus, repeat balloon angioplasty with provisional stenting for in‐stent restenosis is a safe treatment strategy associated with a relatively favorable long‐term outcome. However, the long‐term results might be improved if additional stenting is avoided especially in small vessels. Cathet. Cardiovasc. Intervent. 48:151–156, 1999.

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