Sirolimus-Eluting Stent for the Treatment of In-Stent Restenosis: Comparision with Cutting Balloon Angioplasty

ABSTRACT

BACKGROUND AND OBJECTIVES: The use of drug-eluting stent implantation for in-stent restenosis (ISR) has shown some promising results. This study investigated the clinical and angiographic results of performing sirolimuseluting stent (SES) implantation for the treatment of patients with ISR as compared with treatment with cutting balloon angioplasty (CBA). SUBJECTS AND METHODS: Forty one patients with ISR (43 lesions) were treated with SES implantation and they were retrospectively compared with a group of patient with matched lesions that were treated with CBA (57 patients with 61 lesions). Routine angiographic follow-up was obtained at about 6 months after treatment and the incidence of major adverse cardiovascular events was evaluated. RESULTS: The baseline clinical characteristics, the patterns of ISR and the minimal luminal diameters (MLD) were not different between the two groups. There was no procedural failure and no immediate major cardiovascular adverse events (MACE) in the two groups. There were two target lesion revascularizations during the clinical follow-up in the CBA group and no MACE was found in the SES group (4% vs. 0%, respectively p<0.001). On the follow-up angiogram, the MLD and the stenosis diameter were significantly lower in the SES group than in the CBA group (2.82+/-0.33 vs. 1.80+/-0.82 mm, p<0.001; and 11.3+/-9.6 vs. 41.2+/-24.8%, p<0.001, respectively). The acute gain was significantly higher and the late loss was significantly lower in the SES group than in the CBA group (2.64+/-0.38 vs. 2.02+/-0.44 mm, p<0.001; and 0.21+/-0.28 vs. 0.71+/-0.73, p<0.001, respectively). CONCLUSION: The sirolimuseluting stent was safe, feasible and highly effective for treating the patients suffering with in-stent restenosis as compared with cutting balloon angioplasty.