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

The objective of this study was to assess the angiographic and clinical out come of patients with coronary in-stent restenosis treated with balloon ang ioplasty with provisional stenting. The study included 375 consecutive pati ents with in-stent restenosis managed with balloon angioplasty alone or com bined with stenting. Clinical events were recorded during a 1-year follow-u p period and quantitative analysis was performed on 6-month angiographic da ta. Of the 373 patients (451 lesions) with a successful procedure, 273 were treated with angioplasty alone and 100 with additional stenting. Target le sion revascularization was required in 23.7% of the patients: 20.7% in pati ents with angioplasty and 31.0% in patients with stenting. Angiographic res tenosis rate was 38.9%: 35.8% in the angioplasty group and 47.7% in the ste nt group. Stenting in small vessels was associated with a much higher reste nosis rate than in larger vessels (65.6% vs. 37.5%, respectively; P = 0.01) . Thus, repeat balloon angioplasty with provisional stenting for in-stent r estenosis is a safe treatment strategy associated with a relatively favorab le long-term outcome, However, the long-term result; might be improved if a dditional stenting is avoided especially in small vessels. (C) 1999 Wiley-L iss, Inc.