IN STENT RESTENOSIS (ISR) IN PATIENTS UNDERGOING PERCUTANEOUS CORONARY INTERVENTION (PCI) FOR CORONARY ARTERY DISEASE (CAD)

Authors

  • Waseem Raja Armed Forces Institute of Cardiology/National Institute of Heart Disease (AFIC/NIHD)/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Naseer Ahmed Samore Armed Forces Institute of Cardiology/National Institute of Heart Disease (AFIC/NIHD)/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Mohsin Saif Armed Forces Institute of Cardiology/National Institute of Heart Disease (AFIC/NIHD)/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Javeria Kamran Armed Forces Institute of Cardiology/National Institute of Heart Disease (AFIC/NIHD)/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Sidra Waheed Armed Forces Institute of Cardiology/National Institute of Heart Disease (AFIC/NIHD)/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Naeem Tariq Armed Forces Institute of Cardiology/National Institute of Heart Disease (AFIC/NIHD)/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Farhan Tuyyab Armed Forces Institute of Cardiology/National Institute of Heart Disease (AFIC/NIHD)/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Abdul Hameed Siddiqui Armed Forces Institute of Cardiology/National Institute of Heart Disease (AFIC/NIHD)/National University of Medical Sciences (NUMS) Rawalpindi Pakistan

DOI:

https://doi.org/10.51253/pafmj.v70iSuppl-4.6045

Keywords:

Coronary artery disease, Percutaneous Coronary intervention, Restenosis

Abstract

Objective: To study the frequency of In-Stent Restenosis and its treatment in patients undergoing Percutaneous Coronary Intervention for coronary artery disease.

Study Design: Descriptive cross sectional study.

Place and Duration of Study: Department of Cardiology, Armed Forces Institute of Cardiology & National Institute of Heart disease (AFIC/NIHD) Rawalpindi, from Jul 2017 to Jul 2019.

Methodology: All the patients who underwent Percutaneous Coronary Intervention for Coronary Artery Disease at our institute were considered for this study. A consecutive sampling method was used and inclusion/exclusion criteria was applied. Following data was obtained; 1) Demographic information and clinical risk factors like history of hypertension, hyperlipidemia, diabetes mellitus, smoking, coronary artery disease characteristics
(number of diseased arteries, bifurcation lesions, calcification, chronic total occlusions-CTO and tortuosity) 3), Stent factors (under expansion, fracture, longitudinal miss, stent gap). Data recording, storage, assessment and analysis was done by using SPSS software version 21.

Results: Among 1332 cases, 50 had In-Stent Restenosis with overall prevalence of 3.75%. Mean age of the patients with In-Stent Restenosis was 58.76 (± 9.97), with 45 (90%) male and 5 (10%) female. Diabetes Mellitus was the commonest risk factor (22.9%) followed by Hypertension (18%). Sixty four percent of the patients (n=32) had Single Vessel Coronary Artery Disease, 14 (28%) had Double Vessel Coronary Artery Disease and 4 (8%) had Tripple Vessel Coronary Artery Disease. Left Anterior Descending was the commonest coronary artery that developed In-Stent Restenosis, followed by Right Coronary Artery and Left Circumflex respectively. Previously deployed stents which developed In-Stent Restenosis showed longitudinal geographical miss in 16%, stent under expansion in 6% and stent gap in 4%. There was statistically significant association (p-value=0.02) between stent length and frequency of In-Stent Restenosis and it was commonest in stents longer than 30 mm. Eighty six percent
(n=43) of In-Stent Restenosis cases in our study group was treated with Drug Eluting Stent followed by Drug Eluting Balloon in 32% and Plain Old Balloon Angioplasty in 22%.

Conclusion: History of diabetes mellitus and greater stent length were major risk factors in developing In-Stent Restenosis in our study. DES was the commonest treatment modality used.
Keywords: , , .

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Published

06-01-2021

How to Cite

1.
Raja W, Samore NA, Saif M, Kamran J, Waheed S, Tariq N, et al. IN STENT RESTENOSIS (ISR) IN PATIENTS UNDERGOING PERCUTANEOUS CORONARY INTERVENTION (PCI) FOR CORONARY ARTERY DISEASE (CAD). Pak Armed Forces Med J [Internet]. 2021 Jan. 6 [cited 2024 Jun. 25];70(Suppl-4):S865-70. Available from: https://pafmj.org/PAFMJ/article/view/6045