Drug-eluting stent: a review and update.
The development of stent has been a major advance in the treatment of obstructive coronary artery disease since the introduction of balloon angioplasty. However, neointimal hyperplasia occurring within the stent leading to in-stent restenosis is a main obstacle in the long-term success of percutaneous coronary intervention (PCI). The recent introduction of drug-eluting stents (DES) contributes a major breakthrough to interventional cardiology. Many large randomized clinical trials using DES have shown a remarkable reduction in angiographic restenosis and target vessel revascularization when compared with bare metal stents. The results of these trials also appear to be supported by evidence from everyday practice and non-controlled clinical trials. However, the expanded applications of DES, especially in treating complex lesions such as left main trunk, bifurcation, saphenous vein graft lesions, or in-stent restenosis, are still under evaluation with ongoing studies. With the availability of different types of DES in the market, the issue of cost should not be a deterrent and DES will eventually be an economically viable option for all patients. The adoption of DES in all percutaneous coronary intervention may become a reality in the near future. In this review article, we summarize the recent development and progress of DES as well as compare and update the results of clinical trials.
Htay
Thein
T
Division of Cardiovascular Medicine, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.
Liu
Ming W
MW
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000191:economics; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D020099:Coated Materials, Biocompatible; D003324:Coronary Artery Disease / Q000628:therapy; D023903:Coronary Restenosis / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D003331:Coronary Vessels / Q000187:drug effects / Q000473:pathology; D004337:Drug Carriers; D006131:Growth Inhibitors / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D006801:Humans; D006965:Hyperplasia; D017239:Paclitaxel / Q000627:therapeutic use; D011474:Prosthesis Design; D020123:Sirolimus / Q000627:therapeutic use; D015607:Stents / Q000191:economics; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control; D016896:Treatment Outcome; D017539:Tunica Intima / Q000187:drug effects / Q000473:pathology
D000893:Anti-Inflammatory Agents; D020099:Coated Materials, Biocompatible; D004337:Drug Carriers; D006131:Growth Inhibitors; D017239:Paclitaxel; D020123:Sirolimus