© 2005 by BMJ Publishing Group & British Cardiac Society
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ISCHAEMIC HEART DISEASE
Initial trials of drug eluting stents were in medium size vessels (average 3 mm), but restenosis rates are highest in small vessels. They are also technically difficult to graft. Ardissino and colleagues randomised 257 patients to treatment with either a sirolimus eluting stent (129) or uncoated stent (128). Eligible patients included those with stable angina or acute coronary syndromes found to have a single, uncomplicated, 50–99% stenosis of a vessel < 2.75 cm in diameter. After eight months of follow up, 9.8% of those receiving a sirolimus eluting stent, compared to 53.1% of those receiving a uncoated stent, showed evidence of restenosis (> 50%) (relative risk (RR) 0.18, 95% confidence interval (CI) 0.10 to 0.32; p < 0.001). Furthermore, fewer patients randomised to sirolimus stents experienced major cardiac events. The authors conclude that the use of sirolimus eluting stents in these small arteries likely represents a significant advance, and suggest
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