Original papers
Long-term follow-up of rapamycin-eluting stent implantation in patients with coronary artery disease

Restenosis remains the major limitation of percutanoues coronary interventions (PCI). Widespread use of conventional intracoronary stents has lowered its frequency. However, repeat narrowing of a coronary artery can still affect 10% to 30% of patients post PCI.
Objective: The aim of the study was to assess the efficacy of rapamycin-eluting stent (DES) implantation in patients at highest risk of restenosis in case of conventional bare-metal stent implantation.
Results: Rapamycin-eluting stent implantation was performed in 286 patients, including 8 patients (2.8%) with acute myocardial infarction and 98 (34.2%) patients with unstable angina. Restenosis post previous PCI was the indication for DES implantation in 80.4% of patients. The procedure was successful in all patients. During the average 28.7-month follow-up 6 deaths occurred, including 4 (1.4%) probably coronary-related deaths, and in 8 patients acute myocardial infarction was diagnosed. In 59 (20.6%) patients control coronary angiography was performed 6-9 months after the procedure. In-stent restenosis was diagnosed in one (0.4%) patient and in 18 patients restenosis within 5 mm of either pole of DES was seen. No cases of stent thrombosis were revealed.
Conclusions: In patients with coronary artery disease at highest risk of restenosis in case of conventional bare-metal stent implantation, drug-eluting stents significantly reduce restenosis rate and the need for repeated PCI, thus improving the outcome of percutaneous treatment of coronary artery disease.