Drug-eluting stents: current issues.
Early stent thrombosis occurs in about 1% to 1.5% of patients with drug-eluting stents, very similar to the rate with bare-metal stents. Late stent thrombosis is more of a concern with drug-eluting stents, with an incidence of at least 0.35%. I would urge caution if you feel you have to stop antiplatelet therapy in patients with drug-eluting stents. While neointima formation peaks at 6 months and then may actually regress with bare-metal stents, it continues to grow with drug-eluting stents--although this process appears to plateau by 4 years with sirolimus. With the others, we have to wait and see. We still don't know the best drug-eluting stent. Trials are under way to compare stents with surgery, and the future brings the arrival of a number of exciting new devices and approaches that are now entering clinical trials.
Ong
Andrew T L
AT
Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
Serruys
Patrick W
PW
D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D020099:Coated Materials, Biocompatible; D003331:Coronary Vessels / Q000601:surgery*; D006083:Graft Occlusion, Vascular / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D015994:Incidence; D017202:Myocardial Ischemia / Q000601:surgery*; D015607:Stents
D020099:Coated Materials, Biocompatible