Intervention and antiplatelet regimen
restenosis
RESTENOSIS
All patients were administered loading doses of clopidogrel (300–600 mg) and aspirin (200–300 mg) before the procedure. After sheath insertion at the arterial access site, a bolus dose of unfractionated heparin (70–100 units/kg) was administered. All patients received aspirin (100 mg daily) and clopidogrel (75 mg daily) as a dual antiplatelet (DAPT) maintenance regimen for at least 1 month. Cilostazol (100 mg bid or 200 mg dp daily) was prescribed based on the physician’s discretion as a triple antiplatelet on top of clopidogrel-based DAPT. Some physicians used cilostazol-based DAPT 3–6 months after the index procedure to reduce restenosis.PTA was performed using the standard technique. After successfully crossing the target lesion with a 0.014-inch guidewire, either intraluminally or subintimally, prolonged balloon dilatation with an adequately sized balloon (1–1.1:1 balloon-to-artery ratio) was performed for 2–3 min. Some patients were recanalized via the retrograde or transcollateral approach following unsuccessful reentry into the distal true lumen using an antegrade approach. To minimize crossover from PTA to stent implantation, prolonged balloon dilatation was performed in patients with unsatisfactory results for balloon dilatation. Once the POBA results were acceptable and the procedure was completed, randomization was performed to leave it alone or with additional stenting. In the stenting group, Xpert (Abbott Vascular, Abbott Park, IL, USA) SENSs were used for routine primary stenting.