“What’s past is prologue”: the saga of percutaneous coronary intervention

José Ribamar Costa Jr, Alexandre Abizaid, J. Eduardo Sousa

Drug-eluting stents (DES) were conceived to reduce in-stent neointimal formation, minimising the occurrence of restenosis. Their development was pioneered through a combination of the increased understanding of the biology of restenosis, the selection of drugs that target one or more pathways in the restenotic process, controlled-release drug delivery strategies, and the use of the stent as a delivery platform. The first successful DES programme, the CYPHER® sirolimuseluting stent (Cordis Corporation, Johnson & Johnson, Warren, NJ, USA), was initiated in our centre in São Paulo, Brazil. Between December 1999 and January 2000, 30 patients were enrolled in the sirolimus-eluting FIM trial and received the moderate (n=15) and slow-release (n=15) formulations of this device. Four months later, in only two days, we performed the follow-up of both cohorts, with quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS) evaluation.