TY - JOUR A1 - Hausleiter, Jörg A1 - Kastrati, Adnan A1 - Wessely, Rainer A1 - Dibra, Alban A1 - Mehilli, Julinda A1 - Schratzenstaller, Thomas A1 - Graf, Isolde A1 - Renke-Gluszko, Magdalena A1 - Behnisch, Boris A1 - Dirschinger, Josef A1 - Wintermantel, Erich A1 - Schömig, Albert T1 - Prevention of restenosis by a novel drug-eluting stent system with a dose-adjustable, polymer-free, on-site stent coating JF - European Heart Journal - Clinical research N2 - Aims Drug-eluting stents (DES) represent a major advance in interventional cardiology. Along with the success shown, current DES also present limitations related to the presence of polymer-coating, fixed drug, and dose used. With the ISAR (Individualized Drug-Eluting Stent System to Abrogate Restenosis) project, a DES system has been developed that permits individualized choice of the drug and dose to use for the given patient. The objective of this prospective dose finding study was to assess the feasibility, safety, and efficacy of a polymer-free on-site stent coating with increasing rapamycin doses. Methods and results In this dose finding study, 602 patients were sequentially enrolled in four groups: microporous bare metal stent (BMS), DES stents coated with a 0.5, 1.0, and 2.0% rapamycin solution. The angiographic in-segment restenosis rate at follow-up angiography was the primary study endpoint. In-segment restenosis was significantly reduced from 25.9% with BMS to 18.9, 17.2, and 14.7% with 0.5, 1.0, and 2.0% rapamycin-eluting stents, respectively (P=0.024). Similarly, the need for target lesion revascularization at 1 year follow-up was reduced from 21.5% with BMS to 16.4, 12.6, and 8.8% with 0.5, 1.0, and 2.0% rapamycin-eluting stents, respectively (P=0.006). Conclusion The placement of polymer-free stents coated on-site with rapamycin is feasible and safe. Furthermore, a dose-dependent efficacy in restenosis prevention is achievable with this new DES concept. KW - Restenosis KW - Stents KW - Randomized KW - Rapamycin KW - Polymer Y1 - 2005 U6 - https://doi.org/10.1093/eurheartj/ehi405 VL - 26 IS - 15 SP - 1475 EP - 1481 ER -