Dialogues in Cardiovascular Medicine - Vol 13 . N°4 . 2008





Drug-eluting coronary stents:
stents and stent-ability



     Stents are endoprosthetic scaffolding devices designed to enlarge the vessel lumen, seal dissections and create a rounder, smoother channel. Their advent has significantly advanced the field of interventional cardiology. Yet, metallic stents are associated with intima proliferation, causing in-stent restenosis and subsequent need for reintervention in a substantial number of patients. Considerable efforts have gone into the development of stents covered by an active coating designed to inhibit in-stent restenosis—the drug-eluting stent (DES). They proved to be highly efficacious in reducing reintervention rates, but by inhibiting stent-driven intima hyperplasia, they also delay vascular healing after the procedure, which exposes treated patients to the need for prolonged dual antiplatelet treatment and to the risk of delayed abrupt stent closure. Moreover, the synthetic nonbioerodable polymer containing the drug may be an important trigger of local vascular inflammation, which may ultimately contribute to long-term vulnerability of the implanted stent. Second-generation DES engineered with more biocompatible or even reabsorbable polymers are being developed, which hopefully will make DES equally safe as well as more efficacious than currently available bare metal stents...






© 2010 LES LABORATOIRES SERVIER, an incorporated company of SERVIER All Rights Reserved - Updates