ArticleEuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology2023
Mechanisms and treatment outcomes of ostial right coronary artery in-stent restenosis.
Article in EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 19 citations in OpenAlex.
- Delayed Chimney Stent Fracture After Transcatheter Aortic Valve Replacement.JACC. Case reports · 2026Article
- Ostial right coronary artery lesions: what to know and how to overcome.Cardiovascular intervention and therapeutics · 2026Review
- Excessive Ostial Stent Protrusion: Evaluation of Management Strategies and Clinical Outcomes of the Side Flap Technique.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026Article
- A 79-Year-Old Man with a History of Ischemic Heart Disease Presenting with Right Coronary Artery Aorto-Ostial Stent Deformity and Restenosis: A Case Report.The American journal of case reports · 2025Article
- Predictive Factors and Clinical Outcomes of Stent Malapposition in Calcified Lesions After PCI: A Retrospective Observational Study Based on OCT Assessment.Reviews in cardiovascular medicine · 2025Article
- Age-Related Anatomical Changes in Carotid Artery Stenosis and Its Impact on Postoperative Complications in Stenting and Endarterectomy.CNS neuroscience & therapeutics · 2025Article
- Intravascular ultrasound assessment of stent edge restenosis mechanisms and treatment outcomes following percutaneous coronary intervention.Scientific reports · 2025Article
- From Mechanisms to Management: Tackling In-Stent Restenosis in the Drug-Eluting Stent Era.Current cardiology reports · 2025Review
- Target vessel-specific efficacy and short-term outcomes of rotational atherectomy in the treatment of chronic total occlusion.Frontiers in cardiovascular medicine · 2025Article
- SCAI Expert Consensus Statement on the Management of Calcified Coronary Lesions.Journal of the Society for Cardiovascular Angiography & Interventions · 2024Article
- Management of Stent Underexpansion and Aorto-ostial Lesions.Interventional cardiology (London, England) · 2024Review
- The everolimus eluting Synergy MegatronCatheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2023Article
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Authors and funding
21 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite a high rate of in-stent restenosis (ISR) after stenting the right coronary artery (RCA) ostium, the mechanism of ostial RCA ISR is not well understood.
aimsWe aimed to clarify the cause of ostial RCA ISR using intravascular ultrasound (IVUS).
methodsOverall, 139 ostial RCA ISR lesions were identified with IVUS, pre-revascularisation. Primary ISR mechanisms were classified as follows: 1) neointimal hyperplasia (NIH); 2) neoatherosclerosis; 3) ostium not covered by the stent; 4) stent fracture or deformation; 5) stent underexpansion (old minimum stent area <4.0 mm
resultsThe median duration from prior stenting was 1.2 (first quartile 0.6, third quartile 3.1) years. The primary mechanisms of ISR were NIH in 25% (n=35) of lesions, neoatherosclerosis in 22% (n=30), uncovered ostium in 6% (n=9) (biological cause 53%, n=74), stent fracture or deformation in 25% (n=35), underexpansion in 11% (n=15), and protruding calcified nodules in 11% (n=15) (mechanical cause 47%, n=65). Including secondary mechanisms, 51% (n=71) of ostial RCA ISRs had stent fractures that were associated with greater hinge motion of the ostial-aorta angle during the cardiac cycle. The Kaplan-Meier rate of target lesion failure at 1 year was 11.5%. When the mechanically caused ISRs were treated without new stents, they suffered a higher subsequent event rate (41.4%) compared with non-mechanical causes or mechanical causes treated without restenting (7.8%, unadjusted hazard ratio 6.44, 95% confidence interval: 2.33-17.78; p<0.0001).
conclusionsHalf of the ostial RCA ISRs were due to mechanical causes. Subsequent event rates were high, especially in mechanically caused ISRs treated without the implantation of a new stent.
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