Objective-The risk of in-stent restenosis can be considerably reduced by stents eluting cytostatic compounds. We created a novel drug-eluting stent system that includes several new features in the rapidly evolving field of stent-based drug delivery. Methods and Results-The aim of the present study was the preclinical evaluation of a stent-coating system permitting individual, on-site coating of stents with a unique microporous surface allowing for individualizable, dose-adjustable, and multiple coatings with identical or various compounds, designated ISAR (individualizable drug-eluting stent system to abrogate restenosis). Stents were coated with 0.75% rapamycin solution, and high-performance liquid chromatography (HPLC)-based determination of drug release profile indicated drug release for Ͼ21 days. Rapamycin-eluting microporous (REMP) stents implanted in porcine coronary arteries were safe. To determine the efficacy of REMP stents, this novel drug-eluting stent platform was compared with the standard sirolimus-eluting stent. At 30 days, in-stent neointima formation in porcine coronary arteries was similar in both groups, yielding a significant decrease of neointimal area and injury-dependent neointimal thickness compared with bare-metal stents. Conclusion-The ISAR drug-eluting stent platform as a novel concept for stent coating allows for a safe, effective, on-site stent coating process, thus justifying further clinical evaluation to decrease in-stent restenosis in humans. Key Words: drug-eluting stent Ⅲ rapamycin Ⅲ sirolimus Ⅲ stent platform I n-stent restenosis, the major adverse outcome after percutaneous coronary stent placement, 1 can be successfully reduced by drug-eluting stents (DES) releasing cytostatic compounds. Numerous large clinical trials consistently revealed an impressive reduction of in-stent restenosis in de novo lesions by DES. 2-4 However, in specific patient subsets, such as insulin-dependent diabetic subjects, 5 or in challenging interventional scenarios, like bifurcation stenting, 6 the rate of restenosis remains to be substantial at this point. Moreover, the outcome of treatment of in-stent restenosis within DES is currently not satisfactorily solved. 7 Dose adjustments at the discretion of the interventional cardiologist to individualize the dosage of the compound on the drug-eluting stent may be desirable to enable an individual dose adjustment for specific lesion or patient subsets, eg, higher rapamycin doses for diabetic patients. Further, in future scenarios, stent-coating with multiple compounds, for instance to inhibit smooth muscle cell proliferation and promote re-endothelialization, may be desirable. In addition, the presently approved drugeluting stent platforms use a polymer-based coating for retardation of drug release. There is evidence that application of polymers may lead to hypersensitivity reactions and, in few cases, late cardiac death. 8 Furthermore, the issue of late-stent thrombosis in DES, particularly after discontinuation of antiplatelet therapy, is currently s...