Clinical experience of sirolimus-eluting stents in patients with coronary artery disease at Bangkok Heart Institute.

Drug eluting stents represent one of the fastest growing fields in interventional cardiology today. From a recent study, the sirolimus eluting stent (SES) (CYPHER, Cordis, Johnson & Johnson) appear to demonstrate a remarkable efficacy and safety in preventing restenosis. From the present study, the authors reported clinical experience of SES in 40 consecutive patients with coronary artery disease (CAD) between 25th June and 11th October, 2002. The mean age was 59 +/- 12.16 years (mean +/- SD) and 80 per cent of the patients were male. The majority of the patients had chronic stable angina and most percutaneous coronary interventions were performed by elective procedure (85%). Thirty-five per cent of the patients had single vessel disease and 42.5 per cent of the patients had double vessel disease. The authors successfully implanted 52 (69.3%) SES in 75 target lesions revascularization. Twenty-four (60%) of the patients had more than 1 vessel intervention. Twenty-seven (67.5%) of the patients had complete revascularization by percutaneous coronary intervention (PCI) and only 16 of 27 patients (59.3%) who had complete revascularization with SES. The SES were usually implanted at middle part of the left anterior descending artery (MLAD) (11 lesions), proximal part of the left anterior descending artery (PLAD) (8 lesions), middle part of the right coronary artery (MRCA) (8 lesions) and middle part of the left circumflex artery (MLCX) (6 lesions). The authors had to cover plaque entirely with SES, so SES implantation usually took longer than the bare stent (BS). The authors followed the initial clinical outcome of the patients within 1 month after discharge. Few adverse clinical events were found during 1 month follow-up because SES have a very low rate of restenosis in the short-term so, we have to follow-up the patients over a longer period and will report the clinical outcome in the next study.