Safety of drug-eluting stents.
Drug-eluting stents (DESs) effectively reduce angiographic restenosis and the clinical need for repeat revascularization procedures as compared with bare-metal stents. Widely publicized concerns arose recently about the incidence of late and very late stent thrombosis with the use of first-generation DESs. Recent systematic reviews and large-scale registry studies demonstrated similar rates of overall mortality and myocardial infarction for patients treated with either DESs or bare-metal stents during long-term follow-up. Careful selection of stent type according to patient and lesion characteristics as well as monitoring of adherence to dual antiplatelet therapy could maximize the therapeutic potential of these devices. The purpose of the present Review is to provide the reader with an overview of the benefits and risks of first-generation DESs that could help physicians select the most appropriate stent type for each patient.
Windecker
Stephan
S
Department of Cardiology, University Hospital Bern, Bern, Switzerland. stephan.windecker@insel.ch
Jüni
Peter
P
D023903:Coronary Restenosis / Q000209:etiology* / Q000517:prevention & control; D003328:Coronary Thrombosis / Q000209:etiology* / Q000517:prevention & control; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D015994:Incidence; D017239:Paclitaxel / Q000009:adverse effects; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects; D012307:Risk Factors; D020123:Sirolimus / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D010975:Platelet Aggregation Inhibitors; D017239:Paclitaxel; D020123:Sirolimus