Update on drug-eluting stents for prevention of restenosis.
Despite the success of coronary stent implantations in the last decade, in-stent restenosis due to neointimal hyperplasia remains a problem to overcome. Neointimal hyperplasia is a vascular response to stent injury and mainly consists of proliferation of smooth muscle cells and deposition of extracellular matrix. Recently, local drug delivery has been advocated as a potential strategy to prevent in-stent restenosis. Unprecedented results have been obtained in early clinical studies on sirolimus-eluting and paclitaxel-eluting stents. Trials using various pharmaceutical coatings on different coronary stents are ongoing. More types of drug-eluting stents are expected on the market in the near future. Meanwhile, the evaluation of drug-eluting stents is entering the second phase in which the safety and efficacy in more complex lesion subsets and different clinical presentations are being investigated. Results including cost-benefit analyses are expected to have a tremendous impact on the practice of interventional cardiology in the next decade.
Lee
Chi-Hang
CH
Cardiac Department, National University Hospital, Singapore.
Tan
Huay-Cheem
HC
Lim
Yean-Teng
YT
D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D023903:Coronary Restenosis / Q000517:prevention & control*; D004195:Disease Models, Animal; D016503:Drug Delivery Systems; D054855:Drug-Eluting Stents / Q000009:adverse effects / Q000191:economics / Q000639:trends; D006801:Humans; D017239:Paclitaxel / Q000008:administration & dosage; D011474:Prosthesis Design; D020123:Sirolimus / Q000008:administration & dosage; D050257:Tubulin Modulators / Q000008:administration & dosage
D000900:Anti-Bacterial Agents; D050257:Tubulin Modulators; D017239:Paclitaxel; D020123:Sirolimus