title: Procedural and long-term results of sirolimus-eluting stent in patients at high risk for restenosis.
abstract: OBJECTIVE
  In-stent restenosis still affects 10-50% of long-term outcome after percutaneous coronary intervention (PCI). Large clinical trials have shown that sirolimus-eluting stents (SES) have reduced restenosis rate to 0-9% in lesions at low-moderate risk. The aim of this study was to evaluate long-term clinical and angiographic outcome of SES in a real world population, at very high risk of restenosis.
  
  
  METHODS
  Ninety lesions at high risk of restenosis (lesion length >20 mm, target vessel diameter <2.5 mm, in-stent diffuse restenosis, total occlusions and complex lesions on bypass grafts and bifurcations) were treated in 75 patients. A follow-up was scheduled at 6 months.
  
  
  RESULTS
  Restenosis rate was 16.6% with a focal pattern of presentation in most cases. Subacute in-stent thrombosis occurred in 2.2%. Resteno-sis occurred mainly in small vessels, diabetic patients and in vessels previously treated with brachytherapy.
  
  
  CONCLUSIONS
  The treatment of lesions at high risk of restenosis with SES is safe with a low restenosis rate at follow-up. An aggressive and prolonged antiplatelet regimen is mandatory because of high subacute in-stent thrombosis rates.
authors.affiliation: Invasive Cardiology Unit, Humanitas Clinical Institute, Rozzano, Milan, Italy. patrizia.presbitero@humanitas.it
authors.forename: P
authors.initials: P
authors.lastname: Presbitero
authors.forename: D
authors.initials: D
authors.lastname: Zavalloni
authors.forename: M
authors.initials: M
authors.lastname: Scatturin
authors.forename: F
authors.initials: F
authors.lastname: Marisco
authors.forename: P
authors.initials: P
authors.lastname: Pagnotta
authors.forename: G
authors.initials: G
authors.lastname: Boccuzzi
mesh_terms: D023903:Coronary Restenosis / Q000453:epidemiology / Q000517:prevention & control*; D016503:Drug Delivery Systems; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents; D013997:Time Factors
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus