Preliminary observations regarding angiographic pattern of restenosis after rapamycin-eluting stent implantation.
BACKGROUND
Restenosis after implantation of drug-eluting stents (DES) is a rare phenomenon, occurring more frequently peri-stent.


RESULTS
We evaluated the pattern of restenosis occurring after implantation of DES in unselected lesions. From April 15 to December 6, 2002, we treated 368 patients with 735 lesions by using 841 rapamycin-eluting stents (Cypher, Cordis, a Johnson & Johnson Company). Mean baseline lesion length was 17.48+/-12.19 mm, and mean stent length was 27.59+/-14.02 mm. Follow-up ischemia-driven angiography was performed in 24 patients. Eleven patients had angiographic restenosis (> or =50% diameter stenosis) in 14 stented segments (stent and 5 mm proximal and distal to the stent). The pattern of restenosis in all 14 stented segments was focal, and in 6 of them it was multifocal, occurring inside the stents. Mean length of restenotic lesions was 5.62+/-1.90 mm, with a range from 2.54 to 8.44 mm. One multifocal restenosis involved also the distal stent margin. Intravascular ultrasound evaluation at follow-up, performed in 2 patients, showed significant lumen obstruction attributable to in-stent hyperplasia in both cases. Individual cases can be viewed in the Data Supplement.


CONCLUSIONS
The pattern of restenotic lesions after rapamycin-eluting stent implantation was focal and mostly inside the stent.
Columbus Hospital, Milan, Italy. info@emocolumbus.it
Antonio
A
Colombo
Dejan
D
Orlic
Goran
G
Stankovic
Nicola
N
Corvaja
Vassilis
V
Spanos
Matteo
M
Montorfano
Francesco
F
Liistro
Mauro
M
Carlino
Flavio
F
Airoldi
Alaide
A
Chieffo
Carlo
C
Di Mario
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020123:Sirolimus / Q000627:therapeutic use*; D015607:Stents / Q000009:adverse effects*
D020123:Sirolimus