title: Restenosis after implantation of sirolimus-eluting stent begins suddenly, shows short term progression, and stops suddenly.
abstract: OBJECTIVE
  The peak of restenosis in patients implanted with bare metal stents (BMS) is thought to be 6 months after BMS implantation, but the development of restenosis with respect to time and the peak of restenosis in patients implanted with drug-eluting stents (DES) is not known. This study aims to reveal the rate of development of restenosis with respect to time in patients implanted with DES.
  
  
  METHODS
  A total of 282 patients who underwent sirolimus-eluting stent (SES) implantation in native coronary arteries at our hospital were evaluated by serial quantitative angiography at 3 and 6 months, and based on the latter results, at 1 and 2 years after SES implantation. Clinical data were collected for up to 3 years.
  
  
  RESULTS
  Three-year follow-up data were obtained for 261 patients. The 3-year incidence of clinically driven target-lesion revascularization (TLR) was 6.1% (16/261); of the 16 cases, 5 occurred at 3-month follow-up, 7 at 6-month angiographic follow-up, and 1 at 1-year follow up, respectively. While minimum lumen diameter (MLD) of these vessels that underwent TLR at 6 months decreased rapidly after the 3-month angiographic follow-up, MLD of the vessels with 50-70% stenosis at 6-month angiographic follow-up was almost unchanged at 1-year angiographic follow-up; however, 3 lesions required late (i.e. beyond 1 year) revascularization.
  
  
  CONCLUSIONS
  It is difficult to predict SES restenosis by angiography. SES restenosis begins suddenly, shows short-term progression, and stops suddenly. However, treatment of de novo coronary stenosis with SES is associated with a sustained clinical benefit and a very low incidence of TLR.
authors: Department of Cardiology, Chiba Cardiovascular Center, 575 Tsurumai, Ichihara, Chiba 290-0512, Japan. t.kosei.5150@m8.dion.ne.jp
authors: Kosei
authors: K
authors: Tanaga
authors: Keiichiro
authors: K
authors: Miura
authors: Takahiro
authors: T
authors: Kageyama
authors: Yoshitake
authors: Y
authors: Nakamura
authors: Toshihisa
authors: T
authors: Inoue
authors: Kigen
authors: K
authors: Jo
authors: Takayasu
authors: T
authors: Ishikawa
authors: Akira
authors: A
authors: Miyazaki