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Late Restenosis in Patients Receiving a Polymer-Coated Sirolimus-Eluting Stent
- Rainer Wessely, MD;
- Adnan Kastrati, MD; and
- Albert Schömig, MD
- From Technische Universität, 80636 Munich, Germany.
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TO THE EDITOR:
Background: Drug-eluting stents have been broadly available for more than 2 years. Several studies have shown the efficacy of both sirolimus- and paclitaxel-eluting stents for prevention of coronary in-stent restenosis (1, 2). In-stent restenosis is usually detectable in bare-metal stents within the first 6 to 9 months after stent placement; therefore, this time frame is commonly used as follow-up in trials of drug-eluting stents (3). Angiographic results in bare-metal stents approximately 6 months after placement constitute the peak of neointimal obstruction in most patients (3), and angiographic follow-up at later time points often demonstrates decreased neointimal burden, most likely because of apoptotic or remodeling processes (4). Current commercially available drug-eluting stents use a nonbiodegradable polymeric surface, and there is ongoing discussion about increased late stent thrombosis in patients who receive them (5, 6). Besides late thrombotic …
