Comparison of angiographic patterns of in-stent restenosis between sirolimus- and paclitaxel-eluting stent Chang-Bum Park a, ⁎ , Myeong-ki Hong b , Young-Hak Kim b , Duk-Woo Park b , Ki-Hoon Han b , Cheol Whan Lee b , Duck-Hyun Kang b , Jae-Kwan Song b , Jae-Joong Kim b , Seong-Wook Park b , Seung-Jung Park b a Department of Internal Medicine, Seoul Veterans Hospital, Seoul, South Korea b Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea Received 17 June 2006; received in revised form 9 September 2006; accepted 14 October 2006 Available online 8 February 2007 Abstract Background: Angiographic pattern of in-stent restenosis (ISR) after drug-eluting stent (DES) implantation was known to be different to that after bare metal stent (BMS) implantation. But the different angiographic patterns of ISR and its prognosis between sirolimus-eluting stent (SES) and paclitaxel-eluting stent (PES) has not been properly addressed in large scale studies. Objectives and methods: We evaluated the angiographic pattern of ISR and their subsequent clinical outcomes in 177 ISR lesions of 163 consecutive patients previously treated with SES (n =97) or PES (n = 80) from February 2003 to April 2005. Results: In angiographic ISR pattern, diffuse ISR was more common in PES implantation (SES vs PES; 23.7% vs 48.7%, p = 0.001) mainly because of higher incidence of diffuse intrastent ISR (8.2% vs 33.8%, p b 0.001, respectively) whereas focal ISR was more common in SES implantation (76.3% vs 51.3%, p = 0.001, respectively) mainly because of higher incidence of focal margin ISR (27.8% vs 2.5%, p b 0.001, respectively). Among 177 ISR lesions, clinically driven target lesion revascularization (TLR) was performed in 53.6% in SES implantation and 56.3% in PES implantation ( p = 0.725). Conclusion: Angiographic pattern of ISR differed after SES and PES implantation, but their subsequent TLR rate was similar to both types of DES. © 2006 Elsevier Ireland Ltd. All rights reserved. Keywords: Stents; Angioplasty; Coronary restenosis 1. Introduction Routine stent implantation has been shown to have a better procedural success rate and clinical outcome than balloon angioplasty [1,2]. However, restenosis and repeat revascularization remain significant clinical problems limiting the long-term success of stent implantation [1–3]. The recent introduction of drug-eluting stent (DES) has reduced the incidence of stent-related restenosis to less than 10%, but did not eliminate it completely [4,5]. Previous reports [6,7] showed that the pattern of in-stent restenosis (ISR) has changed into a predominantly focal ISR after DES implantation but the number of patients was small and those results were restricted to sirolimus-eluting stents (SES). Furthermore, any difference of angiographic rest- enotic pattern and their subsequent clinical outcome between SES and paclitaxel-eluting stent (PES) were rarely known. Therefore, we evaluated and compared the characteristics of angiographic pattern of ISR and their clinical outcomes after SES and PES implantation. International Journal of Cardiology 120 (2007) 387 – 390 www.elsevier.com/locate/ijcard ⁎ Corresponding author. Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap-dong, Songpa-gu, Seoul, 138-736, South Korea. Tel.: +82 2 3010 3152; fax: +82 2 475 6898. E-mail address: sjpark@amc.seoul.kr (S.-J. Park). 0167-5273/$ - see front matter © 2006 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijcard.2006.10.014