title: Current application and bioavailability of drug-eluting stents.
abstract: BACKGROUND
  Drug-eluting stents (DES) were developed to reduce the restenosis rate of bare metal stents (BMS) and comprises three main components: i) a metallic scaffold; ii) an antiproliferative drug to reduce or abolish the formation of the neointima; and iii) the polymer, which both enables and controls drug elution into the vessel wall. Over the years, growing evidence has been reported on the safety and efficacy for different indications of DES.
  
  
  METHODS
  Since the introduction of first-generation DES, the technology has been refined, including changes in the alloy, stent design, polymer, drug and drug dose. In 2014, we will usher in a third generation of DES, which will include biodegradable polymers, polymer-free DES and bioabsorbable scaffolds.
  
  
  CONCLUSIONS
  In recent years, considerable progress has been made in DES development. The BMS platform set the groundwork for the development of metal scaffolds with drug-eluting capability to prevent restenosis. Importantly, extensive research has shown long-term safety and efficacy of the newer generation DES. Available data suggest that DES can be safely and effectively used to treat a complex subset of patients and lesions, including patients presenting with acute myocardial infarction, lesions in saphenous vein grafts, chronic total occlusions, multivessel disease, small vessels, long lesions and bifurcations. One of the safety targets is to eliminate stent thrombosis.
authors.affiliation: Medstar Washington Hospital Center, Division of Cardiology , 110 Irving St. NW, Suite 4B1, Washington, DC 20009 , USA +1 202 877 2812 ; +1 202 877 2715 ; ron.waksman@medstar.net.
authors.forename: Ricardo O
authors.initials: RO
authors.lastname: Escárcega
authors.forename: Nevin C
authors.initials: NC
authors.lastname: Baker
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Lipinski
authors.forename: Marco A
authors.initials: MA
authors.lastname: Magalhaes
authors.forename: Sa'ar
authors.initials: S
authors.lastname: Minha
authors.forename: Al-Fazir
authors.initials: AF
authors.lastname: Omar
authors.forename: Rebecca
authors.initials: R
authors.lastname: Torguson
authors.forename: Ron
authors.initials: R
authors.lastname: Waksman
mesh_terms: D001682:Biological Availability; D023903:Coronary Restenosis / Q000517:prevention & control*; D054855:Drug-Eluting Stents; D006801:Humans; D007166:Immunosuppressive Agents / Q000493:pharmacokinetics*; D062645:Percutaneous Coronary Intervention / Q000379:methods*
chemical_list: D007166:Immunosuppressive Agents