Persistent inhibition of neointimal hyperplasia after sirolimus-eluting stent implantation: long-term (up to 2 years) clinical, angiographic, and intravascular ultrasound follow-up.
BACKGROUND
Early results of sirolimus-eluting stent implantation showed a nearly complete abolition of neointimal hyperplasia. The question remains, however, whether the early promising results will still be evident at long-term follow-up. The objective of our study was to evaluate the efficiency of sirolimus-eluting stent implantation for up to 2 years of follow-up.


RESULTS
Fifteen patients with de novo coronary artery disease were treated with 18-mm sirolimus-eluting Bx-Velocity stents (Cordis) loaded with 140 microg sirolimus/cm2 metal surface area in a slow release formulation. Quantitative angiography (QCA) and intravascular ultrasound (IVUS) were performed according to standard protocol. Sirolimus-eluting stent implantation was successful in all 15 patients. During the in-hospital course, 1 patient died of cerebral hemorrhage after periprocedural administration of abciximab, and 1 patient underwent repeat stenting after 2 hours because of edge dissection that led to acute occlusion. Through 6 months and up to 2 years of follow-up, no additional events occurred. QCA analysis revealed no significant change in stent minimal lumen diameter or percent diameter stenosis, and 3-dimensional IVUS showed no significant deterioration in lumen volume. In 2 patients, additional stenting was performed because of significant lesion progression remote from the sirolimus-eluting stent.


CONCLUSIONS
Sirolimus-eluting stents showed persistent inhibition of neointimal hyperplasia for up to 2 years of follow-up.
Degertekin
Muzaffer
M
Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands.
Serruys
Patrick W
PW
Foley
David P
DP
Tanabe
Kengo
K
Regar
Evelyn
E
Vos
Jeroen
J
Smits
Peter C
PC
van der Giessen
Wim J
WJ
van den Brand
Marcel
M
de Feyter
Pim
P
Popma
Jeffrey J
JJ
D000077284:Abciximab; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000009:adverse effects; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000517:prevention & control / Q000601:surgery*; D023903:Coronary Restenosis / Q000517:prevention & control*; D004343:Drug Implants / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006965:Hyperplasia / Q000000981:diagnostic imaging / Q000517:prevention & control*; D007140:Immunoglobulin Fab Fragments / Q000009:adverse effects; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects; D012086:Reoperation; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents / Q000009:adverse effects; D013995:Time; D016896:Treatment Outcome; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000187:drug effects; D018084:Ultrasonography, Interventional
D000911:Antibodies, Monoclonal; D004343:Drug Implants; D007140:Immunoglobulin Fab Fragments; D007166:Immunosuppressive Agents; D010975:Platelet Aggregation Inhibitors; D020123:Sirolimus; D000077284:Abciximab