Sirolimus-Eluting Stents: From Research to Clinical Practice

Sirolimus (Rapamycin, Rapnune®) is a naturally occurring macrocyclic lactone with a potent immunosuppressive action, which was approved by the USA's FDA for use in renal transplantation in September 1999. In-stent restenosis has long been considered the main limitation hampering the long-term efficacy of coronary stenting. Although stent implantation itself has been associated with reduced rates of restenosis compared to balloon angioplasty, in-stent restenosis still persists in up to 40% of patients with complex presentations. Recently, sirolimus-eluting stents implantation has been shown in feasibility studies and in randomized trials to decrease restenosis markedly in selected patients. Based on these findings, sirolimus-eluting stents received CE Mark approval in Europe in April 2002 and are since then commercially available for routine clinical use. Nonetheless, the effects of SES implantation in complex, unselected patients, such as those commonly treated in daily practice ('the real world'), remains largely unknown. This book comprehensively evaluates the impact of SES implantation on the outcomes of patients treated in the real world of interventional cardiology. The authors have evaluated in detail the short- and long-term outcomes of several high risk subsets not currently included in randomized trials.Sirolimus-Eluting Stents: From Research to Clinical Practice, 1 was published 2004 under ISBN 9781841844923 and ISBN 1841844926.