title: Treatment of in-stent restenosis with sirolimus-eluting-stents: results from the prospective German Cypher stent registry.
abstract: OBJECTIVE
  Drug-eluting stents have been reported to effectively reduce in-stent restenosis (ISR). However, the effectiveness and safety have yet been investigated only in small trials or case series. The aim of this prospective large scale registry was to show that treatment of ISR with sirolimus eluting stents (SES) is safe, effective and feasible in daily routine.
  
  
  RESULTS
  The German Cypher registry prospectively enrolled 6,555 patients undergoing implantation with SES for various indications, including 1,533 patients treated for ISR. Follow-up data (median 6.6 months) of this cohort was available for 1,531 patients (99.8%). Of these patients 75.8% were male. Of these patients 36.5% (n = 552) presented with acute coronary syndromes. In total, 1,932 SES were used with successful implantation in 98.9%. MI during hospitalization was observed in 0.7% (n = 11) while in-hospital mortality was only 0.1% (n = 2). MACE-rate at follow-up was 13.8% (n = 211) including a mortality of 1.3% (n = 20) and MI in 1.9% (n = 29). Total revascularization procedures including CABG (1.7%) were necessary in 12.3% (n = 186). Target vessel revascularization (TVR) rate was 9.3% (n = 139) and thus similar to patients with de novo lesions (8.1%, P = 0.69). Ten patients (0.65%) suffered from subacute stent thrombosis Vs. 0.24% observed in patients with de novo lesions (P = 0.03).
  
  
  CONCLUSIONS
  This large registry confirms that treatment of ISR with sirolimus-eluting-stents is effective and save with good clinical results at index procedure and follow-up. TVR was not different from de novo lesions.
authors.affiliation: Department of Cardiology, Kerckhoff Heart Centre, Bad Nauheim, Germany. h.moellmann@kerckhoff-klinik.de
authors.forename: Helge
authors.initials: H
authors.lastname: Möllmann
authors.forename: Albrecht
authors.initials: A
authors.lastname: Elsässer
authors.forename: Holger
authors.initials: H
authors.lastname: Nef
authors.forename: Steffen
authors.initials: S
authors.lastname: Schneider
authors.forename: Christoph A
authors.initials: CA
authors.lastname: Nienaber
authors.forename: Gert
authors.initials: G
authors.lastname: Richardt
authors.forename: Michael
authors.initials: M
authors.lastname: Weber
authors.forename: Malte
authors.initials: M
authors.lastname: Kelm
authors.forename: Benny
authors.initials: B
authors.lastname: Levenson
authors.forename: Tassilo
authors.initials: T
authors.lastname: Bonzel
authors.forename: Ulrich
authors.initials: U
authors.lastname: Tebbe
authors.forename: Georg
authors.initials: G
authors.lastname: Sabin
authors.forename: Thomas
authors.initials: T
authors.lastname: Pfannebecker
authors.forename: Jochen
authors.initials: J
authors.lastname: Senges
authors.forename: Christian W
authors.initials: CW
authors.lastname: Hamm
mesh_terms: D000368:Aged; D054855:Drug-Eluting Stents; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006083:Graft Occlusion, Vascular / Q000453:epidemiology / Q000401:mortality / Q000628:therapy*; D017052:Hospital Mortality; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D020123:Sirolimus / Q000627:therapeutic use*
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus