TY - JOUR JO - EuroIntervention TI - Clinical outcomes after percutaneous coronary intervention for in-stent chronic total occlusion AB - <p><strong>Aims:</strong> The aim of this study was to compare percutaneous coronary intervention (PCI) outcomes in relation to stent optimisation profiles between in-stent chronic total occlusions (CTOs) and de novo CTOs.</p> <p><strong>Methods and results:</strong> We evaluated 1,516 consecutive patients who underwent PCI for 147 in-stent CTOs (9.3%) and 1,439 de novo CTOs between 2007 and 2018. The primary endpoint was target vessel failure (TVF) consisting of a composite of cardiac death, target vessel-related myocardial infarction, or target vessel revascularisation. The final post-stenting intravascular ultrasound (IVUS) images were analysed. Target lesion complexity reflected by the Japanese CTO score was similar, albeit calcification was more prevalent in de novo CTOs, whereas occlusion length &gt;20 mm was more frequent in in-stent CTOs. The technical success (88.4% vs 87.5%, p=0.84) and in-hospital adverse event (1.4% vs 3.6%, p=0.26) rates were similar between CTO types. Among those who received drug-eluting stents, the five-year TVF (11.0% vs 10.7%, p=0.99) and target vessel revascularisation (4.2% vs 3.7%, p=0.81) rates were similar between groups. Total stent length, minimum stent area (5.4&plusmn;1.8 vs 5.5&plusmn;1.8 mm<sup>2</sup>, p=0.77), and maximal plaque burden of the reference segments were largely comparable between groups.</p> <p><strong>Conclusions:</strong> In-stent CTO PCI with drug-eluting stents optimised by IVUS guidance offers as acceptable long-term clinical results as those achieved in de novo CTOs.&emsp;</p> AU - Yoon Yong-Hoon AU - Lee Hyung Pil AU - Lee Seung-Whan AU - Kwon Osung AU - Lee Kyusup AU - Kang Do-Yoon AU - Ahn Jung-Min AU - Park Duk-Woo AU - Kang Soo-Jin AU - Kim Young-Hak AU - Lee Whan Cheol AU - Park Seong-Wook AU - Park Seung-Jung VL - 16 IS - 6 Y1 - 07/08/2020 Y1 - 2020 DOI - 10.4244/EIJ-D-19-00650 SP - e472 EP - e479 KW - chronic coronary total occlusion KW - drug-eluting stent KW - in-stent restenosis PB - Europa Digital & Publishing SE - Coronary interventions UR - https://eurointervention.pcronline.com/article/importance-of-stent-optimization-for-favourable-outcomes-after-percutaneous-coronary-intervention-for-chronic-in-stent-occlusions SN - 1774-024X ER -