Late restenosis following sirolimus-eluting stent implantation.
Despite encouraging results from randomized trials, concerns exist about long-term results of sirolimus-eluting stent implantation. We sought to determine whether in-stent restenosis occurring >1 year ("late") after sirolimus-eluting stent implantation is a real clinical entity. We analyzed data on all sirolimus-eluting stents implanted in our institution before March 2003. During the study period 928 lesions in 433 patients were treated. Angiographic follow-up was performed in 306 patients (70.6%) with 679 lesions (73.2%). Angiography after 1 year was performed only in symptomatic patients. We considered restenosis "early" if it occurred during the first year and late if after 1 year. Late restenosis required demonstration of a widely patent stent at 6 to 9 months, with repeat angiography after 1 year demonstrating restenosis. Restenosis occurred in 160 lesions overall (23.5%). Of the 31 (4.6%) that were documented after 1 year, 13 were excluded from analysis due to absence of 6- to 9-month angiography; the remaining 18 (2.6%, 1.7 to 4.2) fulfilled our criteria for late restenosis (median time of documentation 607 days, interquartile range 511 to 923). In conclusion, late restenosis is an infrequent but real entity; its existence implies we should not discount the possibility of restenosis as the cause of symptoms that develop >1 year after sirolimus-eluting stent implantation.
Cosgrave
John
J
EMO Centro Cuore Columbus, Milan, Italy. cosgravejohn@yahoo.co.uk
Corbett
Simon J
SJ
Melzi
Gloria
G
Babic
Rade
R
Biondi-Zoccai
Giuseppe G L
GG
Airoldi
Flavio
F
Chieffo
Alaide
A
Sangiorgi
Giuseppe M
GM
Montorfano
Matteo
M
Michev
Iassen
I
Carlino
Mauro
M
Colombo
Antonio
A
D000368:Aged; D019917:Blood Vessel Prosthesis Implantation; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents; D013997:Time Factors
D007166:Immunosuppressive Agents; D020123:Sirolimus