title: Quantitative assessment of angiographic restenosis after sirolimus-eluting stent implantation in native coronary arteries.
abstract: BACKGROUND
  Sirolimus-eluting stents (SESs) reduce angiographic restenosis in patients with focal, native coronary artery stenoses. This study evaluated the usefulness of SESs in complex native-vessel lesions at high risk for restenosis.
  
  
  RESULTS
  Angiographic follow-up at 240 days was obtained in 701 patients with long (15- to 25-mm) lesions in small-diameter (2.5- to 3.5-mm) native vessels who were randomly assigned to treatment with SESs or bare-metal stents (BMSs) in the SIRIUS trial. Quantitative angiographic measurements of minimal lumen diameter and percent diameter stenosis were obtained within the treated segment, within the stent, and within its 5-mm proximal and distal edges. Patients treated with SESs had lower rates of binary (>50% diameter stenosis) angiographic restenosis within the segment (8.9% versus 36.3% with the BMS; P<0.001) and within the stent (3.2% versus 35.4% with the BMS; P<0.001). SESs were associated with significantly less late lumen loss within the treated segment, within the stent, and within its 5-mm proximal and distal edges (all P<0.001). The reduction of restenosis with the SES was consistent in patients at risk for restenosis, including those with small vessels, long lesions, and diabetes mellitus. The frequency of late aneurysms was similar in the 2 groups.
  
  
  CONCLUSIONS
  Compared with BMSs, SESs reduced angiographic late lumen loss within the stent and its adjacent 5-mm margins in patients with complex native-vessel lesions.
authors.affiliation: Department of Internal Medicine, Cardiovascular Division, Brigham and Women's Hospital, 75 Francis St, Boston, Mass 02115, USA. jpopma@partners.org
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Popma
authors.forename: Martin B
authors.initials: MB
authors.lastname: Leon
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Moses
authors.forename: David R
authors.initials: DR
authors.lastname: Holmes
authors.forename: Nicholas
authors.initials: N
authors.lastname: Cox
authors.forename: Michelle
authors.initials: M
authors.lastname: Fitzpatrick
authors.forename: John
authors.initials: J
authors.lastname: Douglas
authors.forename: Charles
authors.initials: C
authors.lastname: Lambert
authors.forename: Michael
authors.initials: M
authors.lastname: Mooney
authors.forename: Steven
authors.initials: S
authors.lastname: Yakubov
authors.forename: Richard E
authors.initials: RE
authors.lastname: Kuntz
mesh_terms: D000368:Aged; D001241:Aspirin / Q000627:therapeutic use; D000077144:Clopidogrel; D003323:Coronary Aneurysm / Q000000981:diagnostic imaging / Q000453:epidemiology; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000517:prevention & control; D023921:Coronary Stenosis / Q000628:therapy; D048909:Diabetes Complications / Q000628:therapy; D004311:Double-Blind Method; D004343:Drug Implants; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D020123:Sirolimus / Q000008:administration & dosage / Q000627:therapeutic use*; D015607:Stents; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D004343:Drug Implants; D006493:Heparin; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin; D020123:Sirolimus