Incidence of restenosis after successful coronary angioplasty: a time-related phenomenon. A quantitative angiographic study in 342 consecutive patients at 1, 2, 3, and 4 months.

Abstract

Data from experimental, clinical, and pathologic studies have suggested that the process ofrestenosis begins very early after coronary angioplasty. The present study was performed to determine prospectively the incidence of restenosis with use of the four National Heart, Lung, and Blood Institute and the 50% or greater diameter stenosis criteria, as well as a criterion based on a decrease of 0.72 mm or more in minimal luminal diameter. Patients were recatheterized at 30, 60, 90, or 120 days after successful percutaneous transluminal coronary angioplasty (PTCA). After PTCA all patients received 10 mg nifedipine three to six times a day and aspirin once a day until repeat angiography. Of 400 consecutive patients in whom PTCA was successful (<50% diameter stenosis), 342 underwent quantitative angiographic follow-up (86%) by use of an automated edge-detection technique. A wide variation in the incidence of restenosis was found dependent on the criterion applied. The incidence of restenosis proved to be progressive to at least the third month for all except NHLBI criterion II. At 4 months a further increase in the incidence of restenosis was observed when defined as a decrease of 0.72 mm or more in minimal luminal diameter, whereas the criteria based on percentage diameter stenosis showed a variable response. The lack of overlap between the different restenosis criteria applied affirms the arbitrary nature of angiographic definitions currently in use. Restenosis should be assessed by repeat angiography, and preferably ascertained according to the change in absolute quantitative measurements of the luminal diameter.

Molecular mechanism of green microalgae,Dunaliella salina, involved in attenuating balloon injury-induced neointimal formation

“…An inflated balloon was pushed and pulled through the lumen three times to damage the vessel. The six groups of the animals include sham (no angioplasty), balloon-injured alone, and four doses of EDS (10,20,40 and 80 mg/kg) given to rats daily for 2 weeks before and after balloon injury via gastric intubation (7,19) . At 2 weeks after balloon injury, rats were killed with an over dose of pentobarbital by injection.…”

Brief review: Coronary drug-eluting stents and anesthesia

“…This process generally begins to occur in the first six to eight weeks after stenting, 4 but can be seen beyond one year following stent placement. 5 Drug-eluting stents were introduced to reduce the rate of restenosis. The drug eluted from the stent inhibits smooth muscle and endothelial cell proliferation, 6 thereby delaying the inflammatory response.…”

Restenosis: Repeat Narrowing of a Coronary Artery

“…It usually occurs within 6 months after the initial procedure. 1 Compared with balloon angioplasty alone, where the chance of restenosis is 40%, stents reduce the chance of restenosis to 25%. 2,3 Therefore, the majority of patients having angioplasty today are treated with stents.…”