Progress in treatment by percutaneous coronary intervention: the stent of the future.
First generation drug-eluting stents have considerably reduced in-stent restenosis and broadened the applications of percutaneous coronary interventions for the treatment of coronary artery disease. The polymer is an integral part of drug-eluting stents in that, it controls the release of an antiproliferative drug. The main safety concern of first generation drug-eluting stents with permanent polymers--stent thrombosis--has been caused by local hypersensitivity, delayed vessel healing, and endothelial dysfunction. This has prompted the development of newer generation drug-eluting stents with biodegradable polymers or even polymer-free drug-eluting stents. Recent clinical trials have shown the safety and efficacy of drug-eluting stents with biodegradable polymer, with proven reductions in very late stent thrombosis as compared to first generation drug-eluting stents. However, the concept of using a permanent metallic prosthesis implies major drawbacks, such as the presence of a foreign material within the native coronary artery that causes vascular inflammation and neoatherosclerosis, and also impedes the restoration of the vasomotor function of the stented segment. Bioresorbable scaffolds have been introduced to overcome these limitations, since they provide temporary scaffolding and then disappear, liberating the treated vessel from its cage. This update article presents the current status of these new technologies and highlights their future perspectives in interventional cardiology.
Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
Takashi
T
Muramatsu
Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
Yoshinobu
Y
Onuma
Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
Yao-Jun
YJ
Zhang
Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
Christos V
CV
Bourantas
Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
Alexander
A
Kharlamov
Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
Roberto
R
Diletti
Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
Vasim
V
Farooq
Department of Interventional Cardiology, Andreas Gruentzig Cardiovascular Center, Emory University School of Medicine, Atlanta, Georgia, United States.
Bill D
BD
Gogas
Department of Cardiology, East Lancashire, NHS Trust, Lancashire, United Kingdom.
Scot
S
Garg
Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
Hector M
HM
García-García
Department of Cardiology, Fujita Health University, Toyoake, Japan.
Yukio
Y
Ozaki
Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands. Electronic address: p.w.j.c.serruys@erasmusmc.nl.
Patrick W
PW
Serruys
D000818:Animals; D054855:Drug-Eluting Stents; D006083:Graft Occlusion, Vascular; D006801:Humans; D062645:Percutaneous Coronary Intervention / Q000379:methods / Q000639:trends*; D015607:Stents / Q000639:trends*