Intravascular ultrasound evaluation after sirolimus eluting stent implantation for de novo and in-stent restenosis lesions.
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.
Degertekin
Muzaffer
M
Department of Cardiology, Erasmus Medical Center, Thoraxcenter, Bd. 48, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.
Lemos
Pedro A
PA
Lee
Chi Hang
CH
Tanabe
Kengo
K
Sousa
J Eduardo
JE
Abizaid
Alexandre
A
Regar
Evelyn
E
Sianos
George
G
van der Giessen
Willem J
WJ
de Feyter
Pim J
PJ
Wuelfert
Egon
E
Popma
Jeffrey J
JJ
Serruys
Patrick W
PW
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
D004343:Drug Implants; D007166:Immunosuppressive Agents; D020123:Sirolimus