Direct stenting limits sirolimus-eluting stent edge neointimal thickening

Although SES or other drug-eluting stents (DES) reduce the need for repeated revascularization compared with BMS, these benefits are accompanied by a delay in the normal healing process of the arterial wall to injury. Besides the risk of thrombosis resulting from this delayed healing, edge stenosis has also been raised as a potential limitation for DES. However, the standard SES implantation technique typically follows balloon predilatation, particularly in clinical trials. In this study, we addressed whether the implantation technique, generally chosen at the discretion of the interventional cardiologist, affected the consequences of SES implantation. We showed that direct stenting significantly reduced the neointimal thickness at the SES edge. This result thus suggests that in clinical practice, direct stenting or predilatation with balloon smaller in length that the stent could be preferentially used to limit the SES edge restenosis.