All drug-eluting stents are equal, but some drug-eluting stents are more equal than others.

b t r t a s S g S d s b r a p a T v v p he first battle fought by drug-eluting stents (DES) was ith bare-metal stents. The 2 DES approved by the U.S. ood and Drug Administration, sirolimus drug-eluting tents (S-DES) and paclitaxel drug-eluting stents (P-DES), howed superiority in significantly reducing restenosis rates nd target lesion revascularization rates compared with are-metal stents in a wide range of patient and lesion ubsets. In the past 2 years, we have been witnessing the 2 ES “taking on” each other. In this issue of the Journal, lezi et al. (1) compare the angiographic and clinical utcomes according to vessel size in 2000 consecutive atients at 2 German sites treated with either S-DES or -DES. Overall, there were no differences in death and yocardial infarction rates with respect to vessel size or pecific DES stent type. However, there were significantly igher binary restenosis rates and target lesion revascularzation (TLR) rates in small vessels ( 2.41 mm) compared ith moderate and large vessels. The adverse outcomes in he lower tertile were DES-type specific with a significant eduction in TLR rates favoring S-DES, (8.4% vs. 16.4%). hus, the adaptation of George Orwell’s classic commandent from Animal Farm seems to nicely reflect the current tudy’s assessment of the appropriate vessel characteristics in hoosing between the 2 approved DES.