title: Four-year angiographic and intravascular ultrasound follow-up of patients treated with sirolimus-eluting stents.
abstract: BACKGROUND
  Despite the proven superiority of sirolimus-eluting stents (SESs) compared with bare stents in the first year after implantation, long-term outcomes of patients treated with these novel devices remain unknown. Our goal was to evaluate the clinical, angiographic, and intravascular ultrasound (IVUS) outcomes of patients treated with SESs 4 years after implantation.
  
  
  RESULTS
  The study included 30 patients treated with sirolimus-eluting Bx Velocity stenting (slow release [SR; n=15] and fast release [FR; n=15]). Twenty-six patients underwent 4-year angiographic and IVUS follow-up and had matched assessments at all time points (index and 4-, 12-, 24-, and 48-month follow-up). One death occurred during the study period in a patient with a patent SES. There were no target-vessel revascularizations or thromboses between 2- and 4-year follow-up examinations. There was no stent thrombosis, target-lesion revascularization, death, or myocardial infarction in the SR group up to 4 years. Cumulative event-free survival rate was 87% for the total population (80% in the FR group and 93% in the SR group). In-stent late loss was slightly greater in the FR group (0.41+/-0.49 mm) than the SR group (0.09+/-0.23) after 4 years. One patient in the FR group had a 52% in-stent restenosis lesion. Percent neointimal hyperplasia volume, as detected by IVUS, remained minimal after 4 years (FR=9.1% and SR=5.7%).
  
  
  CONCLUSIONS
  This study confirms the longevity of the optimal outcomes observed in patients treated with sirolimus-eluting Bx Velocity stents 4 years after implantation. In-stent lumen dimensions remained essentially unchanged at 4-year follow-up, particularly in the population treated with the currently available SES (SR formulation).
authors.affiliation: Institute Dante Pazzanese of Cardiology, São Paulo, Brazil.
authors.forename: J Eduardo
authors.initials: JE
authors.lastname: Sousa
authors.forename: Marco A
authors.initials: MA
authors.lastname: Costa
authors.forename: Alexandre
authors.initials: A
authors.lastname: Abizaid
authors.forename: Fausto
authors.initials: F
authors.lastname: Feres
authors.forename: Ana C
authors.initials: AC
authors.lastname: Seixas
authors.forename: Luiz F
authors.initials: LF
authors.lastname: Tanajura
authors.forename: Luiz A
authors.initials: LA
authors.lastname: Mattos
authors.forename: Robert
authors.initials: R
authors.lastname: Falotico
authors.forename: Judith
authors.initials: J
authors.lastname: Jaeger
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Popma
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
authors.forename: Amanda G M R
authors.initials: AG
authors.lastname: Sousa
mesh_terms: D002318:Cardiovascular Diseases; D017023:Coronary Angiography; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular; D006801:Humans; D015994:Incidence; D007700:Kinetics; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents / Q000009:adverse effects* / Q000592:standards; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D020123:Sirolimus