Aims: The aim of this study is to compare the efficacy of sirolimus-eluting stents (SES) on neointimal growth and vessel remodelling for in-stent restenosis versus de novo coronary artery lesions using serial intravascular ultrasound (IVUS). Methods and results: The study population consisted of 86 patients with in-stent restenosis (ISR) (n=41) or de novo lesions (n=45) treated with SES and evaluated by IVUS post-procedure and at follow-up. One 18-mm SES was used for de novo lesions while 16 patients with ISR received >1 SES (total stented length 17.9 mm vs 22.0 mm respectively; P=0.004). At follow-up, no differences were observed between the ISR and de novo groups with respect to changes in the mean external elastic membrane (1.7% vs 1.3%; P=0.53), plaque behind the stent (1.2% vs 3.4%; P=0.49), and lumen areas (0.7% vs 1.9%; P=0.58). No positive remodelling or edge effect was observed. A gap between stents was observed in two patients with ISR, where more prominent, though non-obstructive, neointimal proliferation was noted. Conclusion: Sirolimus-eluting stenting is equally effective at inhibiting neointimal proliferation in de novo and ISR lesions without inducing edge restenosis or positive vascular remodelling.

Restenosis, Sirolimus, Stent, Ultrasound,
European Heart Journal
Department of Cardiology

Degertekin, M, Lemos Neto, P.A, Lee, C.H, Tanabe, K, Sousa, J.E, Abizaid, A.C, … Serruys, P.W.J.C. (2004). Intravascular ultrasound evaluation after sirolimus eluting stent implantation for de novo and in-stent restenosis lesions. European Heart Journal, 25(1), 32–38. doi:10.1016/j.ehj.2003.10.012