Drug-eluting stents: Results, promises and problems

article
In-stent restenosis is the major drawback of percutaneous coronary interventions, occurring in 10-40% of the patients. Recently, new stents have emerged which are loaded with anti-inflammatory, anti-migratory, anti-proliferative or pro-healing drugs. These drugs are supposed to inhibit inflammation and neointimal growth and subsequently in-stent restenosis. In this review article the results of human clinical studies investigating drug-eluting stents are discussed from a clinical point of view, focussing on the efficacy in the prevention of restenosis and their potential side effects. Both success and failure in the field of drug-eluting stents have been described. Successful devices are the sirolimus-eluting and the polymer-based paclitaxel-eluting stents. Potentially dangerous side effects of drug-eluting stents are adverse drug interactions, incomplete stent apposition and increased in-stent thrombosis rates. Demonstration of long-term efficacy is mandatory since in some animal studies a delayed healing has been observed. Currently, the successful drug-eluting stents are under investigation in all types of lesions. We conclude that the results with some drug-eluting stents are promising, but further evidence on long-term efficacy and safety, also in high-risk subgroups, is needed. © 2004 Elsevier Ireland Ltd. All rights reserved. Chemicals / CAS: abciximab, 143653-53-6; angiopeptin, 113294-82-9; batimastat, 130370-60-4, 130464-84-5; cilostazol, 73963-72-1; cyclosporin, 79217-60-0; cytochalasin D, 22144-77-0; dactinomycin, 1402-38-6, 1402-58-0, 50-76-0; dexamethasone, 50-02-2; estradiol, 50-28-2; everolimus, 159351-69-6; latrunculin A, 76343-93-6; mycophenolic acid, 23047-11-2, 24280-93-1; nitric oxide, 10102-43-9; paclitaxel, 33069-62-4; rapamycin, 53123-88-9; tacrolimus, 104987-11-3; tranilast, 53902-12-8; vasculotropin, 127464-60-2
TNO Identifier
238392
ISSN
01675273
Source
International Journal of Cardiology, 99(1), pp. 9-17.
Pages
9-17
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