Mechanisms explaining the late “catch-up” phenomenon after sirolimus-eluting stent implantation

Abstract

Drug-eluting stents (DES) have a significantly reduced in-stent restenosis (ISR). However, there is concern about the durability of the efficacy, i.e., late “catch-up” phenomenon [1,2]. In the bare-metal stent (BMS) era, the ISR occurred predominantly within the first year, which was clinically much more important than late restenosis. However, in the first generation DES era, late ISR leading to late target-lesion revascularization (TLR) beyond 1year has emerged as a new problem. The mechanisms of the late restenosis after the first-generation DES implantation are not fully understood.