title: Intravascular ultrasound evaluation after sirolimus eluting stent implantation for de novo and in-stent restenosis lesions.
abstract: OBJECTIVE
  The aim of this study is to compare the efficacy of sirolimus-eluting stents (SES) on neointimal growth and vessel remodelling for in-stent restenosis versus de novo coronary artery lesions using serial intravascular ultrasound (IVUS).
  
  
  RESULTS
  The study population consisted of 86 patients with in-stent restenosis (ISR) (n=41) or de novo lesions (n=45) treated with SES and evaluated by IVUS post-procedure and at follow-up. One 18-mm SES was used for de novo lesions while 16 patients with ISR received >1SES (total stented length 17.9 mm vs 22.0 mm respectively; P=0.004). At follow-up, no differences were observed between the ISR and de novo groups with respect to changes in the mean external elastic membrane (1.7% vs 1.3%; P=0.53), plaque behind the stent (1.2% vs 3.4%; P=0.49), and lumen areas (0.7% vs 1.9%; P=0.58). No positive remodelling or edge effect was observed. A gap between stents was observed in two patients with ISR, where more prominent, though non-obstructive, neointimal proliferation was noted.
  
  
  CONCLUSIONS
  Sirolimus-eluting stenting is equally effective at inhibiting neointimal proliferation in de novo and ISR lesions without inducing edge restenosis or positive vascular remodelling.
authors.affiliation: Department of Cardiology, Erasmus Medical Center, Thoraxcenter, Bd. 48, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.
authors.forename: Muzaffer
authors.initials: M
authors.lastname: Degertekin
authors.forename: Pedro A
authors.initials: PA
authors.lastname: Lemos
authors.forename: Chi Hang
authors.initials: CH
authors.lastname: Lee
authors.forename: Kengo
authors.initials: K
authors.lastname: Tanabe
authors.forename: J Eduardo
authors.initials: JE
authors.lastname: Sousa
authors.forename: Alexandre
authors.initials: A
authors.lastname: Abizaid
authors.forename: Evelyn
authors.initials: E
authors.lastname: Regar
authors.forename: George
authors.initials: G
authors.lastname: Sianos
authors.forename: Willem J
authors.initials: WJ
authors.lastname: van der Giessen
authors.forename: Pim J
authors.initials: PJ
authors.lastname: de Feyter
authors.forename: Egon
authors.initials: E
authors.lastname: Wuelfert
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Popma
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
mesh_terms: D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000517:prevention & control*; D004343:Drug Implants; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents; D014463:Ultrasonography
chemical_list: D004343:Drug Implants; D007166:Immunosuppressive Agents; D020123:Sirolimus