Polymer-sirolimus-eluting stents in de novo lesions.

Sirolimus has been shown to inhibit vascular smooth muscle cell proliferation and migration. Stents coated with a mixture of polymer and active drug achieved near total inhibition of neointimal hyperplasia in patients with de novo coronary lesions. Larger, randomized trials confirmed these initial results to a large extent; late luminal loss was not only reduced by > 70% in patients with type A lesions, but also in complex situations such as diabetic patients, long lesions, and small vessels < 2.5 mm. Registries containing several thousand patients, however, indicate that under realistic conditions the flawless results of the initial studies could not be reproduced in all patient groups.