Current status of the Xience V^®everolimus-eluting coronary stent system

Abstract

The introduction of drug-eluting stents has led to a marked reduction of restenosis, which is a major limitation of percutaneous coronary intervention for coronary artery disease. The next-generation Xience V® (Abbott Vascular, CA, USA) everolimus-eluting stent was designed to address the limitations of first-generation drug-eluting stents. The cobalt-chromium stent platform with an open-cell design offers excellent deliverability. Moreover, the combination of a thin fluoropolymer eluting the antirestenotic drug everolimus provides both an effective suppression of neointimal tissue and rapid re-endothelialization above and between stent struts in preclinical studies. Large randomized clinical trials comparing the everolimus-eluting stent with the Taxus Express® and Liberté® (Boston Scientific, MA, USA) paclitaxel-eluting stents have shown reduced rates of repeat revascularization, myocardial infarction and stent thrombosis at 1-year follow-up with the everolimus-eluting stent. However, we will have to await long-term (5-year) data from these randomized clinical trials with the everolimus-eluting stent to determine whether the observed benefit is robust. Furthermore, data are currently limited the clinical performance of the everolimus-eluting stent relative to drug-eluting stents other than the Taxus Express and Liberté paclitaxel-eluting stents, although a large number of trials are now being conducted to address these questions. In this article, we provide a comprehensive overview of (pre)clinical studies with the everolimus-eluting stent.

Impact of different stent alloys on human vascular response to everolimus‐eluting stent: An optical coherence tomography study: The OCTEVEREST

“…The PtCr stent series included four stent models across the range of diameters to attempt more uniform drug distribution and plaque scaffolding. All the mechanical and design characteristics of the CoCr‐EES platform were already detailed in the literature .…”

The impact of everolimus versus other rapamycin derivative-eluting stents on clinical outcomes in patients with coronary artery disease: A meta-analysis of 16 randomized trials

“…In contemporary practice, limus-eluting DES, including those eluting everolimus, biolimus A9, zotarolimus, and sirolimus, are used worldwide and have been shown to effectively inhibit neointimal hyperplasia after stent implantation [10][11][12][13][14][15]. However, data from experimental studies have suggested that different limus drugs may have differential effects on re-endothelialization and subsequently on vascular healing [16,17]. Indeed, a preclinical study has shown more rapid endothelialization with everolimuseluting stent (EES) compared with sirolimus-eluting stent (SES) [16].…”

“…However, data from experimental studies have suggested that different limus drugs may have differential effects on re-endothelialization and subsequently on vascular healing [16,17]. Indeed, a preclinical study has shown more rapid endothelialization with everolimuseluting stent (EES) compared with sirolimus-eluting stent (SES) [16].…”

A Study on the Effects of Covered Stents on Tissue Prolapse

“…Drug-eluting stents, bare metal stents which contain an antiproliferative drug [14], have decreased restenosis rates by a relative 50% to 80% [21]. However, first generation drug-eluting stents have been shown to have an increased risk of late stent thrombosis [22] and long-term clinical data of next-generation devices is still unavailable [23].…”