Future stent drug delivery systems.
Drug-eluting stents (DES) with antiproliferative drugs attached via polymers on the stent surface have reduced in-stent restenosis and repeat revascularization compared with bare metal stent (BMS) across nearly all lesion and patient subsets. However, the small number of patients with in-stent restenosis after DES treatment still exists. Furthermore, concerns about long-term safety of DES are raised, particularly regarding the higher-than-expected late-event thrombosis. There is no doubt that the DES will continue to play a pivotal role in the treatment of coronary artery disease, yet future designs need to incorporate features that reduce thrombosis and promote endothelialization along with maintaining the efficacy. This review focuses on novel generation of DES, discussing new programs, including new antiproliferative agents, novel polymeric and non polymeric stents.
Caixeta
A
A
Heart Institute, Brasilia, DF, Brazil.
Abizaid
A
A
Aoki
J
J
Dangas
G
G
Mehran
R
R
D020341:Absorbable Implants; D003324:Coronary Artery Disease / Q000628:therapy; D023903:Coronary Restenosis / Q000517:prevention & control; D003328:Coronary Thrombosis / Q000517:prevention & control; D054855:Drug-Eluting Stents / Q000639:trends*; D004867:Equipment Design; D000068338:Everolimus; D019317:Evidence-Based Medicine; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D011108:Polymers; D011474:Prosthesis Design / Q000295:instrumentation / Q000639:trends; D020123:Sirolimus / Q000031:analogs & derivatives / Q000627:therapeutic use; D016559:Tacrolimus / Q000031:analogs & derivatives / Q000627:therapeutic use
D007166:Immunosuppressive Agents; D011108:Polymers; C117268:pimecrolimus; D000068338:Everolimus; C489443:zotarolimus; C518022:umirolimus; D020123:Sirolimus; D016559:Tacrolimus