Unrestricted Utilization of Sirolimus-Eluting Stents in the “Real World”: The Rapamycin-Eluting Stent Evaluated At Rotterdam Cardiology Hospital (RESEARCH) registry

__Abstract_

In-stent restenosis has long been considered the main limitation hampering the long-term efficacy of coronary stenting. Although stent implantation itself has been associated with reduced rates of restenosis compared to balloon angioplasty, in-stent restenosis still persists in up to 40% of patients with complex presentations. Even though a number of “predictors” of restenosis are known and are helpful in characterizing “high-risk” populations, the incidence of restenosis remains largely unpredictable in an individual basis. In addition to its relatively high rate in some subsets, the treatment of restenosis has been proven to be frequently challenging. In-stent restenosis in its more complex forms may re-occur in up to 80% of patients following percutaneous re-treatment with conventional techniques. Moreover, although intracoronary brachytherapy has been shown effective in reducing the recurrence rate of in-stent restenosis, treatment failure still occurs in approximately 30% of cases after endovascular irradiation.