The first-generation drug-eluting stents and coronary endothelial dysfunction.
Recently, a growing body of clinical data has shown that the first generation of drug-eluting stents (1st-gen DES) implantation could elicit coronary conduit artery vasomotor dysfunction at nonstented reference segments as late as 12 months after implantation compared with that seen with bare-metal stents. The mechanism of this phenomenon is still not fully understood. Pathological studies have implicated delayed arterial healing and poor re-endothelialization after the 1st-gen DES implantation. Given the vast use of DES globally, a thorough understanding of the early and long-term safety of these devices is paramount. Therefore, this article systematically reviews the current clinical, pathophysiological, and histopathological available data regarding 1st-gen DES-associated vascular endothelial dysfunction. Meanwhile, we will also review the newer generation of DES and emerging endothelial-friendly technology.
Department of Cardiology, University of Louisville, Louisville, Kentucky, USA.
Lakshmana K
LK
Pendyala
Xinhua
X
Yin
Jinsheng
J
Li
Jack P
JP
Chen
Nicolas
N
Chronos
Dongming
D
Hou
D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D000818:Animals; D002317:Cardiovascular Agents / Q000008:administration & dosage; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D003331:Coronary Vessels / Q000503:physiopathology*; D054855:Drug-Eluting Stents; D004730:Endothelium, Vascular / Q000503:physiopathology*; D006801:Humans; D017239:Paclitaxel / Q000008:administration & dosage; D011474:Prosthesis Design; D018570:Risk Assessment; D012307:Risk Factors; D020123:Sirolimus / Q000008:administration & dosage; D013997:Time Factors; D016896:Treatment Outcome
D002317:Cardiovascular Agents; D017239:Paclitaxel; D020123:Sirolimus