BACKGROUND: Clinical restenosis after coronary stenting is generally treated by target vessel revascularization (TVR). This study was aimed at reporting the clinical profile and outcomes of patients with symptomatic in-stent restenosis (ISR) who were not submitted to a TVR. METHOD: Patients who presented clinical restenosis after coronary stenting between January 1997 and December 2001 were identified. Clinical and angiographic characteristics and clinical outcomes of patients who did not undergo a new revascularization (no-TVR group) were compared with revascularized patients (TVR group). All of the patients had at least 2 years of follow-up for the occurrence of major adverse cardiac events (MACE) after stent implantation. RESULTS: In the study period, 1,221 stents were implanted in 1,149 patients. ISR was observed in 135 patients (12%), of which 104 had complete clinical and angiographic follow-up, 23 in the no-TVR group and 81 in the TVR group. The mean follow-up period after coronary stenting was 30.8 ± 7.5 months. Patients in the no-TVR group had a significantly higher percent of one vessel disease (82% vs. 47%; P < 0.01). Patients in the no-TVR group had a long-term MACE rate of 21.7% (5 patients: 2 deaths, 3 myocardial infarctions), whereas those submitted to a new revascularization showed a subsequent MACE rate of 9.8% (8 patients: 1 death, 4 myocardial infarctions, 3 coronary artery bypass graft surgery; P = 0.11). CONCLUSION: Patients with clinical ISR not treated with a TVR more frequently presented one-vessel disease and a trend towards higher incidence of MACE when compared to those treated with a new TVR.
Coronary restenosis; Angioplasty; Stents
