Background: Increased drug dose in the overlap segment might be associated with vascular responses. The aim of this study is to investigate the vascular response using IVUS between SES and PES.Methods: A total of 18 patients with overlapping stents (12 SES and 6 PES) were imaged with serial IVUS after procedure and at 9 months. Volumetric IVUS analysis was performed. Vascular responses were assessed at single stent strut (non-OL) regions and the overlap (OL) region.Results: In PES, the changes of mean vascular volume (VVI) and mean peri-stent plaque volume (PVI) were not different. The change of VVI in SES also showed no difference. Although the difference did not reach statistical significance, the change of PVI in SES tended to be less at non-OL regions. There were no significant difference in the frequency of late-acquired ISA with SES and PES in either non-OL regions or OL region.Conclusion: Exaggerated vascular responses were not present at OL region compared with non-OL regions in both SES and PES groups.