Details

Autor(en) / Beteiligte

• YAMAJI, Kyohei
• KIMURA, Takeshi
• SAKAI, Koyu
• GOYA, Masahiko
• IWABUCHI, Masashi
• YOKOI, Hiroyoshi
• NOSAKA, Hideyuki
• NOBUYOSHI, Masakiyo
• MORIMOTO, Takeshi
• NAKAGAWA, Yoshihisa
• INOUE, Katsumi
• SOGA, Yoshimitsu
• ARITA, Takeshi
• SHIRAI, Shinichi
• ANDO, Kenji
• KONDO, Katsuhiro

Titel

Very Long-Term (15 to 20 Years) Clinical and Angiographic Outcome After Coronary Bare Metal Stent Implantation

Ist Teil von

• Circulation. Cardiovascular interventions, 2010-10, Vol.3 (5), p.468-475

Ort / Verlag

Hagerstown, MD: Lippincott Williams & Wilkins

Erscheinungsjahr

2010

Quelle

MEDLINE

Beschreibungen/Notizen

• We previously reported that the long-term luminal response after coronary bare metal stenting is triphasic, with an early restenosis phase spanning the 6 months after the index procedure, an intermediate-term regression phase from 6 months to 3 years, and a late renarrowing phase beyond 4 years. However, the clinical significance of late luminal renarrowing remains unknown. Angiographic and clinical follow-up of the same cohort of 405 patients with successful Palmaz-Schatz stent placement was extended beyond 15 years. Clinical follow-up was completed in 98% of patients at 5 years and in 81% at 15 years. The incidence of death and cardiac death at 15 years was 45.4% and 20.6%, respectively. Paired long-term (4 to 10 years) and very long-term (>10 years) angiographic studies without intercurrent target lesion revascularization were performed in 55 lesions, and minimal luminal diameter further decreased from 1.88±0.50 mm to 1.60±0.73 mm (P=0.002). Late target lesion revascularization after initial stabilization of the stented segments occurred rarely within 4 years. Beyond 4 years, however, the incidence of late target lesion revascularization increased steadily from 3.3% at 4 years to 24.7% at 15 years. The incidence of definite very late stent thrombosis was low (1.5% at 15 years). Luminal renarrowing of the stented segment beyond 4 years was a progressive process extending beyond 10 years. The angiographic observation of late in-stent restenosis was clinically relevant because a corresponding progressive increase in the incidence of late target lesion revascularization was observed beyond 4 years and up to 15 to 20 years after bare metal stent implantation.