Sirolimus-eluting stent implantation in small coronary arteries: a three dimensional intravascular ultrasound study from the SIRIUS trial.
OBJECTIVE
To assess the efficacy of the sirolimus-eluting stent when implanted in smaller caliber vessels using three-dimensional intravascular ultrasound (IVUS) analysis.


METHODS
One hundred and twenty-three patients (69 sirolimus-coated Bx Velocity and 54 control) who underwent successful three-dimensional IVUS at follow up comprised this IVUS substudy from the SIRIUS (SIRolImUS-coated Bx Velocity stent in the treatment of patients with de novo coronary artery lesions) population. To evaluate the impact of vessel size, 2 groups were created using QCA reference vessel diameter (RVD; large vessel group: RVD>/=2.75 mm and small vessel group: RVD<2.75 mm).


RESULTS
Sirolimus-eluting stents significantly reduced neointimal hyperplasia by the same relative magnitude within the stent in small vessels as well as in large vessels. Although sirolimus-eluting stents had favorable effects on lumen area at stent edges in larger vessels, the effect was less in smaller vessels, especially at the proximal edge. IVUS-detected adverse vessel response, such as late-acquired incomplete apposition, did not increase in smaller vessels even with relatively higher dose exposure.


CONCLUSIONS
Sirolimus-eluting stents showed inhibition of neointimal hyperplasia in small vessels compared to bare metal stents with no increase of vascular complications.
Kaneda
Hideaki
H
Center for Research in Cardiovascular Interventions, Stanford University, Stanford, CA 94305, United States.
Ako
Junya
J
Terashima
Mitsuyasu
M
Morino
Yoshihiro
Y
Honda
Yasuhiro
Y
Yock
Paul G
PG
Leon
Martin B
MB
Moses
Jeffrey W
JW
Fitzgerald
Peter J
PJ
D015906:Angioplasty, Balloon, Coronary; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy*; D023903:Coronary Restenosis / Q000517:prevention & control; D054855:Drug-Eluting Stents; D006801:Humans; D006965:Hyperplasia; D021621:Imaging, Three-Dimensional; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D020123:Sirolimus / Q000008:administration & dosage*; D016896:Treatment Outcome; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology; D018084:Ultrasonography, Interventional
D007166:Immunosuppressive Agents; D020123:Sirolimus