Long-term follow-up of patients with sirolimus-eluting stents for treatment of bare-metal in-stent restenosis

Abstract Background Limited data is available on the long-term outcome after sirolimus-eluting stent (SES) implantation for in-stent restenosis. Methods In 3 centers, consecutive patients ( n =100) with percutaneous coronary intervention (PCI) for in-stent restenosis ( n =110) were treated with SES: 28 lesions were focal, 40 diffuse, 17 proliferative, and 15 totally occluded (reference vessel diameter: 3.0+/−0.2 mm, lesion length: 13.8+/−5.7 mm). Results SES implantation was successful in all patients. The mean follow-up was 50+/−12 months. The main univariate predictive factor of definite (4%) or probable (4%) SES thrombosis was revascularization without SES in a non-target site during the initial procedure ( p p p p Conclusions SESs are effective at 4 years in the treatment of high risk patients with complex in-stent restenosis, with a low risk of TLR but a high risk of stent thrombosis. Most of cardiac events related to the target vessel occur during the first year, and are associated to a revascularization without SES in another site during the first procedure.