This Article Full Text Full Text (PDF) All Versions of this Article: 111/18/2326    most recent 01.CIR.0000164271.01172.1Av1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Sousa, J. E. Articles by Sousa, A. G.M.R. Search for Related Content PubMed PubMed Citation Articles by Sousa, J. E. Articles by Sousa, A. G.M.R. Related Collections Catheter-based coronary interventions: stents

(Circulation. 2005;111:2326-2329.)
© 2005 American Heart Association, Inc.

Interventional Cardiology

Four-Year Angiographic and Intravascular Ultrasound Follow-Up of Patients Treated With Sirolimus-Eluting Stents

J. Eduardo Sousa, MD, PhD; Marco A. Costa, MD, PhD; Alexandre Abizaid, MD, PhD; Fausto Feres, MD, PhD; Ana C. Seixas, MD; Luiz F. Tanajura, MD, PhD; Luiz A. Mattos, MD, PhD; Robert Falotico, PhD; Judith Jaeger, BA; Jeffrey J. Popma, MD; Patrick W. Serruys, MD, PhD; Amanda G.M.R. Sousa, MD, PhD

From Institute Dante Pazzanese of Cardiology (J.E.S., A.A., F.F., A.C.S., L.F.T., L.A.M., A.G.M.R.S.), São Paulo, Brazil; University of Florida, Shands-Jacksonville (M.A.C.), Jacksonville, Fla; Cordis, a Johnson & Johnson Company (R.F., J.J.), Warren, NJ; Brigham and Women’s Hospital (J.J.P.), Boston, Mass; and Thoraxcenter, Dijkzigt University Hospital (P.W.S.), Rotterdam, the Netherlands.

Correspondence to Professor J. Eduardo Sousa, MD, PhD, Institute Dante Pazzanese of Cardiology, Avenida Dr Dante Pazzanese, 500—Ibirapuera, 04012180, São Paulo, Brazil.

Received June 15, 2004; de novo received January 17, 2005; accepted January 21, 2005.

Background— Despite the proven superiority of sirolimus-eluting stents (SESs) compared with bare stents in the first year after implantation, long-term outcomes of patients treated with these novel devices remain unknown. Our goal was to evaluate the clinical, angiographic, and intravascular ultrasound (IVUS) outcomes of patients treated with SESs 4 years after implantation.

Methods and Results— The study included 30 patients treated with sirolimus-eluting Bx Velocity stenting (slow release [SR; n=15] and fast release [FR; n=15]). Twenty-six patients underwent 4-year angiographic and IVUS follow-up and had matched assessments at all time points (index and 4-, 12-, 24-, and 48-month follow-up). One death occurred during the study period in a patient with a patent SES. There were no target-vessel revascularizations or thromboses between 2- and 4-year follow-up examinations. There was no stent thrombosis, target-lesion revascularization, death, or myocardial infarction in the SR group up to 4 years. Cumulative event-free survival rate was 87% for the total population (80% in the FR group and 93% in the SR group). In-stent late loss was slightly greater in the FR group (0.41±0.49 mm) than the SR group (0.09±0.23) after 4 years. One patient in the FR group had a 52% in-stent restenosis lesion. Percent neointimal hyperplasia volume, as detected by IVUS, remained minimal after 4 years (FR=9.1% and SR=5.7%).

Conclusions— This study confirms the longevity of the optimal outcomes observed in patients treated with sirolimus-eluting Bx Velocity stents 4 years after implantation. In-stent lumen dimensions remained essentially unchanged at 4-year follow-up, particularly in the population treated with the currently available SES (SR formulation).

Key Words: angiography • restenosis • stents

This article has been cited by other articles:

				H. Kelbaek, L. Klovgaard, S. Helqvist, J. F. Lassen, L. R. Krusell, T. Engstrom, H. E. Botker, E. Jorgensen, K. Saunamaki, S. Aljabbari, et al. Long-Term Outcome in Patients Treated With Sirolimus-Eluting Stents in Complex Coronary Artery Lesions: 3-Year Results of the SCANDSTENT (Stenting Coronary Arteries in Non-Stress/Benestent Disease) Trial J. Am. Coll. Cardiol., May 27, 2008; 51(21): 2011 - 2016. [Abstract] [Full Text] [PDF]

				R. J. Applegate, M. T. Sacrinty, M. A. Kutcher, R. M. Santos, S. K. Gandhi, T. T. Baki, and W. C. Little "Off-label" stent therapy 2-year comparison of drug-eluting versus bare-metal stents. J. Am. Coll. Cardiol., February 12, 2008; 51(6): 607 - 614. [Abstract] [Full Text] [PDF]

				E. Grube, K. D. Dawkins, G. Guagliumi, A. P. Banning, K. Zmudka, A. Colombo, L. Thuesen, K. Hauptman, J. Marco, W. Wijns, et al. TAXUS VI 2-year follow-up: randomized comparison of polymer-based paclitaxel-eluting with bare metal stents for treatment of long, complex lesions Eur. Heart J., November 1, 2007; 28(21): 2578 - 2582. [Abstract] [Full Text] [PDF]

				G. J. Wilson, J. E. Polovick, B. A. Huibregtse, and B. C. Poff Overlapping paclitaxel-eluting stents: Long-term effects in a porcine coronary artery model Cardiovasc Res, November 1, 2007; 76(2): 361 - 372. [Abstract] [Full Text] [PDF]

				J. Daemen and P. W. Serruys Drug-Eluting Stent Update 2007: Part II: Unsettled Issues Circulation, August 21, 2007; 116(8): 961 - 968. [Full Text] [PDF]

				M. Awata, J.-i. Kotani, M. Uematsu, T. Morozumi, T. Watanabe, T. Onishi, O. Iida, F. Sera, S. Nanto, M. Hori, et al. Serial Angioscopic Evidence of Incomplete Neointimal Coverage After Sirolimus-Eluting Stent Implantation: Comparison With Bare-Metal Stents Circulation, August 21, 2007; 116(8): 910 - 916. [Abstract] [Full Text] [PDF]

				A. Marzocchi, F. Saia, G. Piovaccari, A. Manari, E. Aurier, A. Benassi, A. Cremonesi, G. Percoco, E. Varani, P. Magnavacchi, et al. Long-Term Safety and Efficacy of Drug-Eluting Stents: Two-Year Results of the REAL (REgistro AngiopLastiche dell'Emilia Romagna) Multicenter Registry Circulation, June 26, 2007; 115(25): 3181 - 3188. [Abstract] [Full Text] [PDF]

				G. J. Murphy, T. W. Johnson, M. H. Chamberlain, S. I. Rizvi, M. Wyatt, S. J. George, G. D. Angelini, K. R. Karsch, M. Oberhoff, and A. C. Newby Short- and long-term effects of cytochalasin D, paclitaxel and rapamycin on wall thickening in experimental porcine vein grafts Cardiovasc Res, February 1, 2007; 73(3): 607 - 617. [Abstract] [Full Text] [PDF]

				S. Elezi, A. Dibra, J. Mehilli, J. Pache, R. Wessely, A. Schomig, and A. Kastrati Vessel Size and Outcome After Coronary Drug-Eluting Stent Placement: Results From a Large Cohort of Patients Treated With Sirolimus- or Paclitaxel-Eluting Stents J. Am. Coll. Cardiol., October 3, 2006; 48(7): 1304 - 1309. [Abstract] [Full Text] [PDF]

				R. Gupta, F. Al-Ali, A. J. Thomas, M. B. Horowitz, T. Barrow, N. A. Vora, K. Uchino, M. D. Hammer, L. R. Wechsler, and T. G. Jovin Safety, Feasibility, and Short-Term Follow-Up of Drug-Eluting Stent Placement in the Intracranial and Extracranial Circulation Stroke, October 1, 2006; 37(10): 2562 - 2566. [Abstract] [Full Text] [PDF]

				M. Takano, T. Ohba, S. Inami, K. Seimiya, S. Sakai, and K. Mizuno Angioscopic differences in neointimal coverage and in persistence of thrombus between sirolimus-eluting stents and bare metal stents after a 6-month implantation Eur. Heart J., September 2, 2006; 27(18): 2189 - 2195. [Abstract] [Full Text] [PDF]

				G. S. Mintz and N. J. Weissman Intravascular Ultrasound in the Drug-Eluting Stent Era J. Am. Coll. Cardiol., August 1, 2006; 48(3): 421 - 429. [Abstract] [Full Text] [PDF]

				R Waksman, I M Leitch, J Roessler, H Yazdi, R Seabron, F Tio, R W Scott, R I Grove, S Rychnovsky, B Robinson, et al. Intracoronary photodynamic therapy reduces neointimal growth without suppressing re-endothelialisation in a porcine model Heart, August 1, 2006; 92(8): 1138 - 1144. [Abstract] [Full Text] [PDF]

				S. R. Dixon, C. L. Grines, and W. W. O'Neill The Year in Interventional Cardiology J. Am. Coll. Cardiol., April 18, 2006; 47(8): 1689 - 1706. [Full Text] [PDF]

				M. Valgimigli, P. Malagutti, C. A.G. van Mieghem, S. Vaina, J. M. Ligthart, G. Sianos, and P. W. Serruys Persistence of Neointimal Growth 12 Months After Intervention and Occurrence of Delayed Restenosis in Patients With Left Main Coronary Artery Disease Treated With Drug-Eluting Stents J. Am. Coll. Cardiol., April 4, 2006; 47(7): 1491 - 1494. [Full Text] [PDF]

				P. Roy-Chaudhury, V. P. Sukhatme, and A. K. Cheung Hemodialysis Vascular Access Dysfunction: A Cellular and Molecular Viewpoint J. Am. Soc. Nephrol., April 1, 2006; 17(4): 1112 - 1127. [Abstract] [Full Text] [PDF]

				M. S. Lee, N. Kapoor, F. Jamal, L. Czer, J. Aragon, J. Forrester, S. Kar, S. Dohad, R. Kass, N. Eigler, et al. Comparison of Coronary Artery Bypass Surgery With Percutaneous Coronary Intervention With Drug-Eluting Stents for Unprotected Left Main Coronary Artery Disease J. Am. Coll. Cardiol., February 21, 2006; 47(4): 864 - 870. [Abstract] [Full Text] [PDF]

				M. J. Price, E. Cristea, N. Sawhney, J. A. Kao, J. W. Moses, M. B. Leon, R. A. Costa, A. J. Lansky, and P. S. Teirstein Serial Angiographic Follow-Up of Sirolimus-Eluting Stents for Unprotected Left Main Coronary Artery Revascularization J. Am. Coll. Cardiol., February 21, 2006; 47(4): 871 - 877. [Abstract] [Full Text] [PDF]

				R. Wessely, A. Schomig, and A. Kastrati Sirolimus and Paclitaxel on Polymer-Based Drug-Eluting Stents: Similar But Different J. Am. Coll. Cardiol., February 21, 2006; 47(4): 708 - 714. [Abstract] [Full Text] [PDF]

				P. W. Serruys, M. J.B. Kutryk, and A. T.L. Ong Coronary-Artery Stents N. Engl. J. Med., February 2, 2006; 354(5): 483 - 495. [Full Text] [PDF]

				J. Aoki, A. Colombo, D. Dudek, A. P. Banning, J. Drzewiecki, K. Zmudka, F. Schiele, M. E. Russell, J. Koglin, P. W. Serruys, et al. Peristent Remodeling and Neointimal Suppression 2 Years After Polymer-Based, Paclitaxel-Eluting Stent Implantation: Insights From Serial Intravascular Ultrasound Analysis in the TAXUS II Study Circulation, December 20, 2005; 112(25): 3876 - 3883. [Abstract] [Full Text] [PDF]