We compared intravascular ultrasound findings of drug-eluting stents (DES) vs bare-metal stents (BMS) in saphenous vein graft (SVG) interventions in 148 lesions in 135 pts [87 DES-treated lesions (62 sirolimus-eluting and 25 paclitaxel-eluting stents) vs 61 BMS- treated lesions] including follow-up findings in 27 in-stent restenosis (ISR) lesions (11 DES vs 16 BMS). Results: Graft age was 10.8짹5.9 years. ISR occurred less frequently in the DES group [11/87 (12.6%) vs. 16/61 (26.2%), p=0.035]; also, ISR length was shorter (8.27짹6.54 vs. 15.5짹5.5mm, p=0.005) and percent neointimal hyperplasia was less (51.8짹26.0 vs. 63.8짹23.6%, p=0.028) in the DES group. In the BMS group, minimum stent area (MSA, p=0.002), percent stent expansion (p=0.003), reference segment plaque burden (p=0.005), and lesion remodeling index (p=0.032) were greater in pts with ISR compared with pts without ISR. In the DES group, lesion remodeling index was greater in pts with ISR compared with pts without ISR (p=0.025), but there were no other significant differences between pts with vs without ISR (Table). Conclusions: Compared to BMS implantation, DES implantation in SVG lesions has more favorable outcomes (fewer and less severe ISR). Positive remodeling is associated with ISR in both BMS and DES implantation. However, pharmacologic inhibition of neointimal hyperplasia blunts all of the other predictors of ISR.