Re-Stenosis of a Sirolimus-Coated Stent in a Heart Transplant Recipient With Allograft Vasculopathy

Outcomes of Bare Metal versus Drug-eluting Stents in Allograft Vasculopathy

“…3,4 It has been postulated that the benefits seen in native coronary artery disease with DES vs BMS may also be applied to discrete allograft lesions, but there are limited and conflicting data. [4][5][6][7][8] This study was undertaken to determine whether the implantation of a DES vs a BMS for the treatment of discrete coronary lesions in the transplanted heart could reduce in-stent restenosis (ISR) and improve clinical outcomes.…”

Re-stenosis After Drug-eluting Stents in Cardiac Allograft Vasculopathy

“…26,27 In an earlier study we presented the first case of in-stent re-stenosis (88% lesion at 3 months) in a sirolimus-coated stent in a heart transplant recipient with allograft vasculopathy. 28 Since then two studies using DES suggested a favorable re-stenosis outcome in transplant vasculopathy. 13,14 Specifically, Tanaka et al 14 showed a DES re-stenosis rate of 19% and a BMS re-stenosis rate of 31%.…”

Treatment of allograft vasculopathy in heart transplantation

“…The use of stents in combination with methods (sirolimus or paclitaxel coating, brachytherapy) that virtually eliminate restenosis in native atherosclerosis seems attractive for CAV [147,148]. However, published data on their results are scarce, and restenosis has been described in anecdotal reports [149]. Given the diffuse nature of CAV, it its unlikely that they will change the natural history of CAV.…”