Prognosis and Management of Recurrent Stenosis After Pulmonary Vein Stenting A Prospective Study

被引：0

作者：

Wang, Xiaolei ^{[1
]}

Yu, Jie ^{[2
]}

Wang, Cheng ^{[1
]}

Li, Yanjie ^{[1
]}

Hou, Xumin ^{[1
]}

Ma, Lan ^{[3
]}

He, Ben ^{[1
]}

Cao, Yunshan ^{[4
]}

Pan, Xin ^{[1
]}

机构：

[1] Shanghai Jiao Tong Univ, Sch Med, Shanghai Chest Hosp, Dept Cardiol, 241 West Huaihai Rd, Shanghai 200030, Peoples R China

[2] Yantai Mt Hosp, Dept Cardiol, Yantai, Peoples R China

[3] Shanghai Jiao Tong Univ, Shanghai Chest Hosp, Sch Med, Dept Echocardiog, Shanghai, Peoples R China

[4] Univ Elect Sci & Technol China, Sichuan Prov Peoples Hosp, Dept Heart Lung & Vessels Ctr, 2006 Xiayuan Ave, Chengdu 611731, Peoples R China

来源：

JACC-CLINICAL ELECTROPHYSIOLOGY | 2024年 / 11卷 / 01期

关键词：

balloon angioplasty; in-stent restenosis; pulmonary vein stenosis; stent-; in-stent; vascular patency; BARE METAL STENTS; BALLOON ANGIOPLASTY; RESTENOSIS; ABLATION; IMPLANTATION; CATHETER;

D O I：

10.1016/j.jacep.2024.09.022

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND Pulmonary vein stenting is effective for severe pulmonary vein stenosis, which is limited by restenosis. The assessment and management of in-stent restenosis (ISR) are inadequate, and follow-up outcomes after reintervention remain unknown. OBJECTIVES This study aimed to assess the prognosis and management of pulmonary vein ISR and determine whether the modified stent-in-stent strategy is superior to balloon angioplasty (BA) in treating ISR. METHODS The authors conducted a prospective observational study on patients with severe pulmonary vein stenosis post radiofrequency ablation for atrial fibrillation. RESULTS A total of 107 patients with 174 severely stenosed veins underwent successful stenting. Forty-three veins among 36 patients experienced ISR (24.7%, 43 of 174). Veins developing ISR had smaller diameter stents (7.8 f 0.8 mm vs 9.2 f 0.7 mm; P = 0.008). Restenosis veins were assigned to BA group or stent-in-stent group. Success rate was 95.7% for BA and 90.0% for stent-in-stent. Twelve veins experienced recurrent ISR, including 2 in stent-in-stent group (11.1%, 2 of 18) and 10 in BA group (45.5%, 10 of 22). The risk of recurrent stenosis was significantly lower in veins treated with the stent-in-stent method than with BA (HR: 0.21; 95% CI: 0.07-0.64; P = 0.02). Patients in the stent-instent group had greater exercise endurance and better World Health Organization cardiac functional class compared with BA group (F = 7.2; P < 0.05; and F = 4.4; P < 0.05, respectively) at 6- and 12-month follow-ups. CONCLUSIONS Our modified stent-in-stent implantation approach is superior to BA for treating pulmonary vein ISR, by reducing recurrent restenosis rate and improving exercise endurance. (JACC Clin Electrophysiol. 2025;11:46-55) (c) 2025 by the American College of Cardiology Foundation.

引用

页码：46 / 55

页数：10

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