Quantitative Assessment of Angiographic Restenosis After Sirolimus-Eluting Stent Implantation in Native Coronary Arteries

Authors:
  • MLMartin B. Leon
    Martin B. Leon
  • JMJeffrey W. Moses
    Jeffrey W. Moses
  • DHDavid R. Holmes
    David R. Holmes
  • NCNicholas Cox
    Nicholas Cox
  • MFMichelle Fitzpatrick
    Michelle Fitzpatrick
  • JDJohn Douglas
    John Douglas
  • CLCharles Lambert
    Charles Lambert
  • MMMichael Mooney
    Michael Mooney
  • SYSteven Yakubov
    Steven Yakubov
  • RKRichard E. Kuntz
    Richard E. Kuntz
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Abstract
Background— Sirolimus-eluting stents (SESs) reduce angiographic restenosis in patients with focal, native coronary artery stenoses. This study evaluated the usefulness of SESs in complex native-vessel lesions at high risk for restenosis. Methods and Results— Angiographic follow-up at 240 days was obtained in 701 patients with long (15- to 25-mm) lesions in small-diameter (2.5- to 3.5-mm) native vessels who were randomly assigned to treatment with SESs or bare-metal stents (BMSs) in the SIRIUS trial. Quantitative angiographic measurements of minimal lumen diameter and percent diameter stenosis were obtained within the treated segment, within the stent, and within its 5-mm proximal and distal edges. Patients treated with SESs had lower rates of binary (>50% diameter stenosis) angiographic restenosis within the segment (8.9% versus 36.3% with the BMS; P P P Conclusions— Compared with BMSs, SESs reduced angiographic late lumen loss within the stent and its adjacent 5-mm margins in patients with complex native-vessel lesions.

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