CONTEXT Although vascular brachytherapy is the only approved therapy for restenosis following bare-metal stent implantation, drug-eluting stents are now being used. Data on the relative merits of each are limited. OBJECTIVE To determine the safety and efficacy of the sirolimus-eluting stent compared with vascular brachytherapy for the treatment of patients with restenosis within a bare-metal ...

OBJECTIVES The purpose of this research was to determine the relative safety and efficacy of multiple (> or =2) overlapping Cypher sirolimus-eluting stents (SES) (Johnson & Johnson, New Brunswick, New Jersey). BACKGROUND Overlapping coronary stents are common. The periprocedural and late clinical and angiographic consequences of overlapped coronary stents are not clearly defined, particularly...

Background: Cutting Balloon angioplasty (CBA) may be a useful treatment modality for in-stent restenosis (ISR) as it maintains a stable position during dilatation and results in potentially less injury than plain old balloon angioplasty (POBA). The purpose of this study was to compare CBA and POBA with intracoronary radiation therapy (IRT) for in-stent restenosis (ISR). Methods: We selected 157...

BACKGROUND Impaired endothelial function is a key event in the atherosclerosis process and predicts future cardiovascular events in subjects with and without coronary artery disease (CAD). We performed the first prospective study evaluating whether early measurement of brachial artery endothelium-dependent dilation (flow-mediated dilation [FMD]) after coronary stenting could predict occurrence ...

PURPOSE Serial change of the coronary flow velocity reserve was evaluated with fast velocity-encoded cine magnetic resonance imaging (MRI) for noninvasive detection of restenosis after coronary stent implantation. METHOD In total, 60 MRI flow studies were performed in 10 patients with coronary artery disease who undersvent elective successful stent implantation to the lesion in the proximal l...

The aim of this study was to assess the incidence and angiographic patterns of in-stent restenosis 6 months after the implantation of NIR gold-coated stents in an unselected patient population. One hundred and sixteen consecutive patients were treated with the implantation of 149 NIR gold-coated stents. The majority of the patients (52%) had unstable angina or acute myocardial infarction. The b...

Restenosis and thrombosis are potentially fatal complications of coronary stenting with a recognized multifactorial etiology. The effect of documented risk factors, however, cannot explain the preponderance of certain lesion types, stent designs, and implantation configurations for the development of these complications. Local hemodynamic factors, low endothelial shear stress (ESS) in particula...

Coronary optical coherence tomography (OCT) has the potential to identify in-stent neoatherosclerosis, which is a possible risk factor for late acute coronary events after drug-eluting stent implantation. The purpose of this study was to investigate differences between mid-term and late in-stent restenosis after stent implantation by quantitative and semiautomated tissue property analysis using...

OBJECTIVE In this study, we evaluated the utility of 16-slice MDCT (multidetector computed tomography) to assess stent patency after coronary artery stenting. MATERIALS AND METHODS Retrospective ECG-gated CT-angiography using 16-slice MDCT was performed in 52 consecutive patients with coronary artery stents. Qualitative assessment of 61 coronary stent lumens by MDCT is reported, and the reaso...

As noted repeatedly, the treatment of in-stent restenosis remains one of the most vexing shortcomings in interventional cardiology. Coronary restenosis is often manifested by symptom recurrence, which is translated into an increased rate of repeat revascularization. In this issue, Radke and colleagues report the results of a well-conducted meta-analysis with data gathered from published reports...