Late Restenosis in Patients Receiving a Polymer-Coated Sirolimus-Eluting Stent

  1. Rainer Wessely, MD;
  2. Adnan Kastrati, MD; and
  3. Albert Schömig, MD
  1. From Technische Universität, 80636 Munich, Germany.
    1. Figure 1. The first patient received a sirolimus-eluting stent to treat proximal left anterior descending stenosis ( ) with an appropriate angiographic follow-up result at 7 months ( ). Later, after 20.4 months, the patient presented with late restenosis in the sirolimus-eluting stent ( ). Of note, a bare-metal stent implanted around the same time did not reveal progressive restenosis ( ). The second patient received a sirolimus-eluting stent for treatment of de novo right coronary artery stenosis ( ) with adequate result at angiographic follow-up at 7 months ( ). Later, after 18.9 months, the patient presented with late restenosis in the sirolimus-eluting stent ( ). Of note, a bare-metal stent implanted around the same time showed regression of in-stent neointima (see ).
      View larger version:
        Figure 1. The first patient received a sirolimus-eluting stent to treat proximal left anterior descending stenosis ( ) with an appropriate angiographic follow-up result at 7 months ( ). Later, after 20.4 months, the patient presented with late restenosis in the sirolimus-eluting stent ( ). Of note, a bare-metal stent implanted around the same time did not reveal progressive restenosis ( ). The second patient received a sirolimus-eluting stent for treatment of de novo right coronary artery stenosis ( ) with adequate result at angiographic follow-up at 7 months ( ). Later, after 18.9 months, the patient presented with late restenosis in the sirolimus-eluting stent ( ). Of note, a bare-metal stent implanted around the same time showed regression of in-stent neointima (see ). Coronary angiograms of 2 patients who received sirolimus-eluting stents and presented with late in-stent restenosis.part A, white arrowpart Bparts C and Dparts A through C, black arrowspart E, arrowpart Fparts G and HFigure 2
      • Figure 2. Minimal lumen diameter in bare-metal stents reached the minimum at 7-month follow-up in both patients and increased thereafter. In contrast, minimal lumen diameter steadily decreased in both polymer-coated sirolimus-eluting stents, demonstrating delayed neointimal growth.
        View larger version:
          Figure 2. Minimal lumen diameter in bare-metal stents reached the minimum at 7-month follow-up in both patients and increased thereafter. In contrast, minimal lumen diameter steadily decreased in both polymer-coated sirolimus-eluting stents, demonstrating delayed neointimal growth. Development of in-stent minimal lumen diameter as a measure of neointimal growth in patients receiving a sirolimus-eluting stent and a bare-metal stent at approximately the same time.

        Responses to this article

        « Previous | Next Article »Table of Contents