Backgrounds: The restenosis rate after stent implantation is high in small vessel. Recent studies have demonstrated that thin strut stents are associated with significant reduction in angiographic restenosis rate in vessels with reference diameter > 2.8mm. But, datas regarding the effectiveness of thin strut stents in small vessel lesions less than 2.8 mm is limited. Therefore, in this study, we report the results of stenting in small vessels less than 2.8mm in reference diameter with Arthos Pico짰 stent, a thin strut cobalt-chromium stent. Methods: Retrospective analysis was done on 83 lesions in 81 consecutive patients (42 males, mean age: 63.9짹8.3) who underwent coronary stenting with Arthos Pico짰, a thin strut cobalt-chromium stent. The reference diameter of all analyzed lesion was less than 2.8mm and stent diameter was less than 2.8mm also. Angiographic follow up data was available for 25 lesions (30.1%). Results: Arthos Pico짰 stents were implanted in 83 lesions (reference vessel diameter of 2.63짹0.22mm, lesion length: 12.3짹4.3mm) with procedural success achieved in 82/83(98.8%) of lesions. The percent diameter stenosis decreased from 82.4짹13.0 to 1.15짹3.50. The preinterventional MLD, post interventional MLD and acute gain was 0.46짹0.35mm, 2.65짹0.21mm and 2.18짹0.43mm, respectively. There was 1 case of cardiac death, 3 cases of periprocedural MI and 3 cases of rehospitalization. Follow up angiography data was available for 25 lesions in 24 patients. Angiographic restenosis was documented in 11 lesions (44.0%) with the follow up percent diameter stenosis of 46.7짹32.4. The follow up MLD, Late loss and Loss index were 1.40짹0.89mm, 1.12짹0.79mm and 0.54짹0.33, respectively. Target vessel revascularization was performed in 5 patients. Clinical follow up data was available in 78 patients with a 12 month event free survival rate of 85.7%. Conclusions: Although the procedural success rate was high, stenting in small vessels less than 2.8mm with thin strut stents was associated with relatively high in-stent restenosis rate. For small vessels < 2.8mm, stent strut thickness and materials may not have signficant influence on the degree of angiographic restenosis rate.