Immediate and six month results of balloon angioplasty in the treatment ofintra-stent restenosis in symptomatic patients

The aim of this prospective study was to assess the clinical and angiograph ic immediate and 6 month results of balloon angioplasty in intra-stent rest enosis. Quantitative anagiographic analysis (Philips DCl) was performed bef ore and after implantation of the stent, before and after angioplasty for r estenosis and at the 6 month control procedure. The study included 59 patie nts with 65 stents with an intra-stent restenosis. Restenosis was diffuse ( 10 mm) in 70% of cases, and focal in 30% of cases. The length of the stent was 16 +/- 7 mm (Palmaz-Schatz : 58%). The diameter of the balloon used for angioplasty was 2.9 +/- 0.4 mm and the maximal inflation pressure was 10 /- 3 bars. The success rate was 100% with no complications. Control coronary angiograp hy was performed in 92% of patients after an average of 5.9 months. The ang iographic restenosis rate was 54% and revascularisation was required in 21 patients (36%). The restenosis rate was higher in cases of diffuse intra-st ent restenosis (64%) than in focal restenosis (29%), p= 0.02. The authors conclude that balloon angioplasty for intra-stent restenosis is safe and carries a high success rate. Nevertheless, the angiographic reste nosis rate at 6 months seems to be higher, especially in cases of diffuse r estenosis.