Traitement de la resténose intra-stent au ballon actif Peeper

Présentation au sujet: "Traitement de la resténose intra-stent au ballon actif Peeper"— Transcription de la présentation:

1 Traitement de la resténose intra-stent au ballon actif Peeper
Pre-procedure Post-procedure 6-month In-stent Reference vessel diameter 2.84 ± 0.39mm 2.86 ± 0.39mm 2.82 ± 0.38mm Minimum lumen diameter 0.91 ± 0.43mm 2.18 ± 0.39mm 2.08 ± 0.41mm Late lumen loss 0.07 ± 0.31mm Diameter stenosis 68.1 ± 13.8% 23.9 ± 9.8% 25.9 ± 11.7% In-segment 2.79 ± 0.43mm 2.77 ± 0.42mm 1.98 ± 0.41mm 1.94 ± 0.39 0.03 ± 0.32mm 29.1 ± 9.9% 29.9 ± 10.6%

2 6- and 12-Month Clinical Results
All BMS DES Major Adverse Cardiac Event 5 (6.5%) 2 3 9 (11.8%) 7 Cardiac death - Non-fatal MI 1 (1.3%) 1 TLR (clinically driven) 3 (3.9%) 7(9.2%) 6 TVR (clinically driven)

3 Etude comparative ballon actif
PEPCAD II, comparative, randomisée ballon actif SeQuent Please versus actif Taxus liberté : Résultat à 3 ans Analyse en ITT Suivi SeQuent Please (n=66) TAXUS (N=65) P LLL in-stent À 6 mois 0.19 ± 0.39 0.45 ± 0.68 0.01 Réstenose binaire intra-segment 7% 20.3% 0.06 TLR À 12 mois 6.3% 15.4% 0.15 À 3 ans 7.6% 18.5% 0.055 MACE 9.1% 21.5% 0.08 15.2% 27.7% 0.062 Comparé au stent actif à libération de paclitaxel, SeQuent Please présente des résultats angiographique et clinique plus favorable à 6 mois et 3 ans de suivi.

4 Paclitaxel-Coated Balloon Catheter Versus Paclitaxel-Coated Stent for the Treatment of Coronary In-Stent Restenosis Martin Unverdorben, MD; Christian Vallbracht, MD; Bodo Cremers, MD; Hubertus Heuer, MD; Christian Hengstenberg, MD; Christian Maikowski, MD; Gerald S. Werner, MD; Diethmar Antoni, MD; Franz X. Kleber, MD; Wolfgang Bocksch, MD; Matthias Leschke, MD; Hanns Ackermann, PhD; Michael Boxberger, PhD Ulrich Speck, PhD; Ralf Degenhardt, PhD; Bruno Scheller, MD.

5 Paclitaxel-eluting Balloon Catheter Versus Repeat Sirolimus-eluting Stent for The Treatment of Sirolimus-eluting Stent Restenosis Seiji Habra, Kazushige Kadota, Naoki Saito, Suguru Otsuru, Daiji Hasegawa, Yoshikazu Shigemoto, Takeshi Tada, Hiroyuki Tanaka, Yasushi Fuku, Naoki Oka, Tsuyoshi Goto, Kazuaki Mitsudo Kurashiki central hospital, Kurashiki-shi, Japan Methods : From June 2004 to december 2010, 221 consecutive patients with 245 lesions after revascularization for SES restenosis were enrolled. Follow-up angiogram was obtained 6 to 8 month after procedure. All of the initial SES were implanted in de novo lesions. We compared characteristics of patients and lesions between the two groups (PEB for SES restenosis : PEB groupe, n=131, repeat SES implatation for SES restenosis : SES group, n=114) Results : No significant differences were observed in clinical characteristics between the two groups. Reference diameter (RD) and minimal lumen diameter (MLD) were similar between the two groups (RD : 2.83 ± 0.42mm vs 2.91 ± 0.48, p=0.2, MLD : 0.85 ± 0.51mm vs 0.91 ± 0.52mm, p=0.4). Lesion lenght was longer in the DEB group (15.5 ± 9.0mm vs 13.3 ± 6.9, p=0.033). Acute gain was larger in the SES group (1.20 ± 0.62mm vs 1.71 ± 0.63mm, p<0.0001). Follow-up rate was 91% (223/245 lesions). The incidence of recurrent restenosis was 19.1% in the DEB group and 24.1% in the SES group (p=0.4). DEB group led to a significant reduction in 6-8 month late lumen loss (0.27 ± 0.68mm vs 0.63 ± 0.74mm, p=0.0002) and in target lesion revascularization (13.0% vs 23.2%, p=0.049) compared to SES group. Conclusion : In patients with SES restenosis, PEB provided much better angiographic outcomes than repeat SES implantation.

6 Dans notre centre Toutes les resténoses sont traitées au ballon actif:
Accès précoce au ballon actif Réalisation de nombreux cas de resténose augmentés par Delux Toutes les resténoses sont traitées au ballon actif: Très peu de nouveau Stent Très peu de retours Ballon coaté au Sirolimus…