title: "Angiographic late catch-up" phenomenon after sirolimus-eluting stent implantation.
abstract: BACKGROUND
  Although several randomized trials have shown that sirolimus-eluting stent (SES) substantially reduces in-stent restenosis, recent studies have suggested the possibility of late catch-up after SES implantation. We investigated long-term angiographic outcomes after SES implantation in real-world practice.
  
  
  METHODS
  This study was conducted on 195 patients with 253 lesions who underwent the first and long-term angiographic follow-up after SES implantation. First follow-up was done at near 6 months after SES implantation. Long-term angiographic follow-up was defined as that performed at least 36 months after index procedure. Angiographies in patients who experienced target lesion revascularization at the time of the first angiographic follow-up were excluded from the current analysis.
  
  
  RESULTS
  Minimal luminal diameter at long-term angiographic follow-up was significantly smaller compared with that at the first follow-up (2.21 ± 0.65 vs. 2.40 ± 0.55, p<0.001). In-stent late lumen loss between the first and long-term follow-up tended to be larger compared with that between SES implantation and the first follow-up (0.19 ± 0.47 vs. 0.15 ± 0.39, p=0.298). There was a trend for increased incidence of coronary artery aneurysm (1.6% and 7.5% at the first and long-term follow-up) and stent fracture (4.3% and 10.3%). Two stent aneurysms and one stent fracture were related with definite very late stent thrombosis.
  
  
  CONCLUSIONS
  An "angiographic late catch-up" phenomenon and a trend toward increased incidence of coronary artery aneurysm and stent fracture were found at a median 46.5-month angiographic follow-up compared with a median 6-month follow-up.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Inje University College of Medicine, Busan Paik Hospital, Cardiovascular Research Institute, Busan, South Korea.
authors.forename: Tae-Hyun
authors.initials: TH
authors.lastname: Yang
authors.forename: Doo-Il
authors.initials: DI
authors.lastname: Kim
authors.forename: Han-Young
authors.initials: HY
authors.lastname: Jin
authors.forename: Young-Wan
authors.initials: YW
authors.lastname: Cho
authors.forename: Sang Ryul
authors.initials: SR
authors.lastname: Chung
authors.forename: Dong-Kie
authors.initials: DK
authors.lastname: Kim
authors.forename: Yong-Bok
authors.initials: YB
authors.lastname: Kim
authors.forename: Jae-Sik
authors.initials: JS
authors.lastname: Jang
authors.forename: Ung
authors.initials: U
authors.lastname: Kim
authors.forename: Sang-Hoon
authors.initials: SH
authors.lastname: Seol
authors.forename: Dae-Kyeong
authors.initials: DK
authors.lastname: Kim
authors.forename: Dong-Soo
authors.initials: DS
authors.lastname: Kim
mesh_terms: D003323:Coronary Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology*; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging* / Q000209:etiology; D003331:Coronary Vessels / Q000473:pathology; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D020123:Sirolimus / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D020123:Sirolimus