Persistent inhibition of neointimal hyperplasia after sirolimus-eluting stent implantation: long-term (up to 2 years) clinical, angiographic, and intravascular ultrasound follow-up
January 2002
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BACKGROUND: Early results of sirolimus-eluting stent implantation showed a nearly complete abolition of neointimal hyperplasia. The question remains, however, whether the early promising results will still be evident at long-term follow-up. The objective of our study was to evaluate the efficiency of sirolimus-eluting stent implantation for up to 2 years of follow-up. METHODS AND RESULTS: Fifteen patients with de novo coronary artery disease were treated with 18-mm sirolimus-eluting Bx-Velocity stents (Cordis) loaded with 140 microg sirolimus/cm2 metal surface area in a slow release formulation. Quantitative angiography (QCA) and intravascular ultrasound (IVUS) were performed according to standard protocol. Sirolimus-eluting stent implantation was successful in all 15 patients. During the in-hospital course, 1 patient died of cerebral hemorrhage after periprocedural administration of abciximab, and 1 patient underwent repeat stenting after 2 hours because of edge dissection that led to acute occlusion. Through 6 months and up to 2 years of follow-up, no additional events occurred. QCA analysis revealed no significant change in stent minimal lumen diameter or percent diameter stenosis, and 3-dimensional IVUS showed no significant deterioration in lumen volume. In 2 patients, additional stenting was performed because of significant lesion progression remote from the sirolimus-eluting stent. CONCLUSION: Sirolimus-eluting stents showed persistent inhibition of neointimal hyperplasia for up to 2 years of follow-up.
- Male
- Adult
- Aged
- Aged, 80 and over
- Female
- Humans
- Middle aged
- Research Support, Non-U.S. Gov't
- Follow-Up Studies
- Treatment Outcome
- Coronary Angiography
- Drug Implants/administration & dosage
- Sirolimus/*administration & dosage
- Ultrasonography, Interventional
- *Stents/adverse effects
- Reoperation
- Time
- Coronary Restenosis/*prevention & control
- *Blood Vessel Prosthesis Implantation/adverse effects/instrumentation
- Antibodies, Monoclonal/adverse effects
- Coronary Arteriosclerosis/diagnosis/prevention & control/*surgery
- Hyperplasia/*prevention & control/radiography/ultrasonography
- Immunoglobulin Fab Fragments/adverse effects
- Immunosuppressive Agents/administration & dosage
- Platelet Aggregation Inhibitors/adverse effects
- Tunica Intima/drug effects/radiography/ultrasonography
- stent
- follow-up
- month
- patient
- 2 years
- sirolimus-eluting
- sirolimus-eluting stent implantation
- lesion
- restenosi
- neointimal hyperplasia
- neointimal
- circulation
- study
- sirolimus-eluting stents
- implantation
- hyperplasia
- 20- month follow-up
- volume
- table
- lumen
