Abstract 18297: Peri-stent Contrast Staining After Drug-eluting Balloon Angioplasty for Treatment of Coronary In-stent Restenosis

Abstract

Background: Peri-stent contrast staining (PSS) induced by sirolimus-eluting stent (SES) implantation has been reported and the PSS rate was about 2%. It is said that PSS is an abnormal vessel reaction and is related to stent thrombosis. However, it remains unknown whether PSS arises after drug-eluting balloon (DEB) angioplasty. We report on PSS which arose after DEB angioplasty in the in-stent restenosis (ISR) lesion in relation to previously deployed stents. Methods: From September 2008 to October 2011, 378 consecutive patients with 453 lesions (42 de novo and 411 ISR) underwent DEB angioplasty in our hospital. The 411 ISR lesions were classified according to the previously deployed stent: SES, 182; paclitaxel-eluting stent (PES), 61; zotarolimus-eluting stent (ZES), 54; everolimus-eluting stent (EES), 34; biolimus-eluting stent (BES), 16; bare metal stent (BMS), 64. All patients underwent midterm follow-up coronary angiography (f/u CAG) at 6 months after DEB angioplasty, and those without restenosis underwent late f/u CAG at 12 months after midterm f/u. Results: The PSS rates were as follows: overall 3.3% (15/153); de novo, 0% (0/42); SES, 4.40% (8/182); PES, 6.56% (4/61); ZES, 1.85% (1/54); EES, 0% (0/34); BES, 0% (0/16); BMS, 3.13% (2/64). There were no significant differences between each PSS lesion, between first (SES and PES) and second (ZES, EES, and BES) generation drug-eluting stents, and between de novo lesions and each generation group of drug-eluting stent. Stent thrombosis has not occurred. Conclusion: PSS can arise after DEB angioplasty for ISR. Compared with the previous report on PSS after SES implantation, PSS occurred more frequently after DEB angioplasty than after SES implantation. With respect to stent thrombosis, long-term follow-up of patients with PSS after DEB angioplasty is necessary.