Coronary disease & ACS

Sirolimus-Eluting Iron Bioresorbable Scaffolds vs Everolimus-Eluting Stents for Percutaneous Coronary Intervention: A Randomized Trial (IRONMAN II)

J Am Coll CardiolPublished Randomised controlled trial

Primary result · Lesion-level in-segment LLLResult — go to the resultDifference 0.08 mm 95% CI −0.02 to 0.18

Authors' conclusion

In IRONMAN-II, the sirolimus-eluting IBS was noninferior to CoCr-EES for 2-year in-segment LLL, QFR, and OCT-derived flow area. Clinical event rates were also comparable between groups although non-ischemia-driven revascularization rates were higher after IBS.

Study context

Population
Patients with CAD, myocardial ischemia and 1 or 2 de novo target lesions
Participants
518 patients
Comparison
Iron bioresorbable scaffold (IBS) vs cobalt chromium everolimus-eluting stents (CoCr-EES)
  • IBSn = 259
  • CoCr-EESn = 259reference
Primary endpoint
Angiographic in-segment late lumen loss (LLL)
Follow-up
2 years
Methodological detailsprospective, multicentre (36 centres in China), single-blinded, non-inferiority
  • Prospective
  • Multicentre (36 centres in China)
  • Single-blinded
  • Non-inferiority

Primary result

Lesion-level in-segment LLL

Difference

0.08 mm

95% CI −0.02 to 0.18

P = 0.03 for non-inferiority

By group

IBS vs CoCr-EES
difference 0.08 mm (95% CI −0.02 to 0.18); P for non-inferiority = 0.03

As reported in the abstract

Secondary outcomes

OutcomeIBSCoCr-EESDifference (95% CI)P value
Target vessel QFR (powered secondary) · 2 yearsmean 0.90 (SD 0.13)mean 0.92 (SD 0.09)−0.02 (−0.04 to 0)P for non-inferiority = 0.05
OCT flow area (powered secondary) · 2 yearsmean 6.92 (SD 3.48) mm²mean 6.64 (SD 2.44) mm²0.27 (−0.09 to 0.63)P for non-inferiority < 0.0001
OutcomeIBSCoCr-EESHR (95% CI)P value
Target lesion failure · 2 years7.4%5.4%1.37 (0.69–2.73)P = 0.37
  • Optical coherence tomography (OCT) flow area (powered secondary): OCT in first 25 participant pairs

Patient-oriented composite endpoint, death, MI

No significant between-group differences

Safety

Events

OutcomeIBSCoCr-EES
Device thrombosis01

Binary restenosis and revascularization

Higher with IBS; most events non-ischemia-driven

Original publication

Sirolimus-Eluting Iron Bioresorbable Scaffolds vs Everolimus-Eluting Stents for Percutaneous Coronary Intervention: A Randomized Trial (IRONMAN II). J Am Coll Cardiol. Published 11 February 2026. doi:10.1016/j.jacc.2025.12.024

Summarised from the published abstract; every number is checked against it

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