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(Circulation. 2003;108:248.)
© 2003 American Heart Association, Inc.

Editorials

Restenosis

The Mouse That Roared

Spencer B. King, III, MD

From Cardiology of Georgia, Atlanta.

Correspondence to Spencer B. King III, MD, Fuqua Heart Center, 95 Collier Rd, NW, Suite 2075, Atlanta, GA 30309. E-mail sking@acri.com

Key Words: Editorials • restenosis • stents

An extract of the first 250 words of the full text is provided, because this article has no abstract.

No development in interventional cardiology has created a stir like the drug-eluting stent for preventing restenosis. The attention of the medical community, the press, and the public has been intense and rightfully so, because restenosis has been the bane of interventional cardiology for the past 25 years. As we cardiologists celebrate the potential demise of our nemesis restenosis, we should also be honest in assessing how serious a villain he currently is.

See p 257

Although preclinical studies showed modest improvements in restenosis, the first human trials of drug-eluting stents promised its complete demise. The first experience in humans and the RAVEL trial (RAndomized study with the sirolimus-eluting Bx VELocity balloon-expandable stent)¹ showed no restenosis and pointed mechanistically to almost complete inhibition of neointimal formation. With the broader application of the technique in the SIRIUS trial (multicenter randomized double-blind study of the SIRolImUS-coated Bx Velocity stent in the treatment of patients with de novo coronary artery lesions),² cardiologists discovered that restenosis was markedly reduced but was not eliminated. Now in the first post-market experiences, we are beginning to learn something of the mechanisms by which restenosis occurs. This is essential if further progress is to be made on establishing the cause of the residual restenosis and potential solutions. Lemos et al³ have provided some valuable early insights into the pattern of restenosis occurring following the use of drug-eluting stents. The article by Lemos et al³ examines the follow-up angiographic and intravascular ultrasound findings in patients who were treated with drug-eluting . . . [Full Text of this Article]

Related Article:

Coronary Restenosis After Sirolimus-Eluting Stent Implantation: Morphological Description and Mechanistic Analysis From a Consecutive Series of Cases

Pedro A. Lemos, Francesco Saia, Jurgen M.R. Ligthart, Chourmouzios A. Arampatzis, Georgios Sianos, Kengo Tanabe, Angela Hoye, Muzaffer Degertekin, Joost Daemen, Eugene McFadden, Sjoerd Hofma, Pieter C. Smits, Pim de Feyter, Willem J. van der Giessen, Ron T. van Domburg, and Patrick W. Serruys
Circulation 2003 108: 257-260. [Abstract] [Full Text]

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