Are sirolimus-eluting stents superior to paclitaxel-eluting stents in patients with small-vessel disease?
Adnan Kastrati and Albert Schömig*
Correspondence *Deutsches Herzzentrum, Technische Universität München, Lazarettstra
e 36, 80636 München, Germany
Email aschoemig@dhm.mhn.de
This article has no abstract so we have provided the first paragraph of the full text.
DESs are an important advance in the prevention of restenosis.1 Opinion on DESs2 has, however, fluctuated between enthusiasm and concern, with the latter often being a consequence of flawed study design.3 In recent years, we have witnessed an explosive growth in the number of well-designed randomized trials investigating the value of DESs—more than for any other device in cardiology. We have learnt that, in comparison with bare-metal stents, DESs are generally more effective and are equally safe, but that the efficacy and safety of DESs can differ between the various types. The performance of currently available DESs is thought to be most affected by the antiproliferative drug and the polymer that controls its release kinetics.1 Furthermore, we know that differences in performance between DES types can become more evident in high-risk patient or lesion subsets,4 and that these groups might serve as a 'stress test', challenging devices of inferior quality.
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