Predictive factors of restenosis after successful percutaneous transluminal coronary angioplasty

Seok, Jun Ho; Kim, Sung Mok; Bae, Sung Hwa; Kim, Bong Jun; Lee, Hak Jun; Yoon, Ji Sung; Shin, Dong Gu; Kim, Yeong Jo; Shim, Bong Sup

Abstract

OBJECTIVE
Restenosis after successful PTCA remains the main limitation of this technique. Restenosis is a response to injury of the vessel wall, platelet aggregation, thrombus formation, liberation of growth factors, cellular hyperplasia involving predominantly smooth muscle proliferation and migration, and intercellular matrix formation. The identification of risk factors for restenosis could help to prevent and reduce the impact of this phenomenon. We undertook this study to evaluate retrospectively the association between risk factors and restenosis after PTCA
METHODS
We studied 123 patients and 174 lesions that underwent successful PTCA and the follow-up period (from PTCA to follow-up angiography) was 8.2+/-5.8 months in all patients. They were divided into two groups according to the restenosis. Clinical feature, lesional feature, PTCA procedural feature, and other risk factors were compared. Restenosis was defined as the cutoff point of >50% in diameter stenosis at angiographic follow-up.
RESULTS
1) Restenosis was found in 68 lesions after successful PTCA(39.1%). 2) Clinical features of restenosis group are similar to no restenosis group 3) Thrombus (p=0.002), total occlusion(p=0.001), severity of stenosis in the initial lesion(p=0.013) and residual stenosis(p=0.001) were found to be independently associated with restenosis, whereas other lesional characteristics were not. 4) Balloon inflation duration(p=0.017) and dissection(p=0.002) were found to be independently associated with restenosis, whereas other procedural characteristics were not.
CONCLUSION
Thrombus, total occlusion, dissection, severity of stenosis in the initial lesion, balloon inflation time, residual stenosis were found to be associated with restenosis after PTCA in our study.