[Sirolimus-eluting stent for in-stent restenosis treatment: single center results in an unselected study population].

Background: Sirolimus-eluting stents have already proved to be efficient in the prevention of restenosis in de novo lesions and have been already proposed as a potential treatment of in-stent restenosis. In the present study, we evaluated the effectiveness of sirolimus-eluting stent implantation in unselected patients with in-stent restenosis.

Methods: Fifty consecutive patients (59 lesions) were treated with sirolimus-eluting stents for instent restenosis. The incidence of major adverse cardiovascular events and restenosis was evaluated at 1-year clinical and angiographic follow-up.

Results: At baseline, 54% of the lesions were complex (46% proliferative and 8% total occlusions). Small vessel size (< or = 2.5 mm) was present in 30%, a long lesion (> 20 mm) in 25%, and diabetes in 42% of the patients. The angiographic follow-up was obtained in 47 patients (55 lesions). Restenosis was observed in 13% of the lesions. At the 1-year follow-up, the incidence of major adverse cardiovascular events was 16% (4% acute myocardial infarction, 12% target lesion revascularization).

Conclusions: This study confirms the efficacy of sirolimus-eluting stents for the treatment of instent restenosis in an unselected population of consecutive patients at high risk of restenosis and with a broad range of morphological lesion patterns.