Through the drug-eluting stent labyrinth.
For interventional cardiologists restenosis has represented the main limit for the successful long-term treatment of coronary artery disease. The past 2 years witnessed the extraordinary results of drug-eluting stents (DES), putting this technique at the center stage. The safety and efficacy of sirolimus and paclitaxel-eluting stents have been proved in large prospective, multicenter, randomized trials (RAVEL, SIRIUS, TAXUS II). It is possible that the introduction of DES will lead to substantial changes in the therapeutic and/or the economic strategies of the treatment of ischemic coronary artery disease (increase in the complexity of patients treated, reduction in surgical indications, growing costs). Realizing the potential value of this technology will require the successful management of more complex coronary situations (for lesions and patients characteristics). Many extreme situations are still unexplored, although for some of them studies are currently in progress or already being planned.
Guagliumi
Giulio
G
Cardiovascular Department, Ospedali Riuniti, Bergamo. guagliumig@interfree.it
Musumeci
Giuseppe
G
Vassileva
Angelina
A
Tespili
Maurizio
M
Valsecchi
Orazio
O
D015906:Angioplasty, Balloon, Coronary; D000972:Antineoplastic Agents, Phytogenic; D020099:Coated Materials, Biocompatible; D003327:Coronary Disease / Q000628:therapy*; D023903:Coronary Restenosis / Q000517:prevention & control*; D003365:Costs and Cost Analysis; D006801:Humans; D007166:Immunosuppressive Agents; D017239:Paclitaxel; D016032:Randomized Controlled Trials as Topic; D020123:Sirolimus; D015607:Stents / Q000009:adverse effects
D000972:Antineoplastic Agents, Phytogenic; D020099:Coated Materials, Biocompatible; D007166:Immunosuppressive Agents; D017239:Paclitaxel; D020123:Sirolimus