Drug-Eluting Stents, Restenosis and Revascularization

Ramcharitar, Steve; Gaster, Anne Louise; Daemen, Joost; Serruys, Patrick W.

doi:10.1007/s00059-007-2994-z

Cited by 14 publications

(7 citation statements)

References 90 publications

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“…25 However, in practice, coronary bifurcations are a predictor of restenosis with BMSs, but not always with DESs. 26 In our study, coronary bifurcation was not a predictor of restenosis, which supports that coronary bifurcation may not be a predictor of restenosis in the DES era.…”

Section: Circulation Journal Vol73 December 2009supporting

confidence: 73%

Lack of Clinical Benefit of Improved Angiographic Results With Sirolimus-Eluting Stents Compared With Paclitaxel and Zotarolimus-Eluting Stents in Patients With Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Choi

Rha

Chen

et al. 2009

Circ J

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rug-eluting stents (DESs) have been rapidly accepted in real world clinical practice by the interventional community, largely being used in percutaneous coronary interventions (PCI). 1 Previous randomized trials have reported that the first generation DESs, including sirolimus-eluting stents (SES; Cypher™) and paclitaxel-eluting stents (PES; Taxus™) reduced the incidence of restenosis and the need for revascularization over 6-12 months' follow-up compared with bare metal stents (BMSs). 2,3 Recent trials of DESs in acute myocardial infarction (AMI) have reported that DESs are superior to BMSs in reducing the need for repeat revascularization. [4][5][6][7] However, DES implantation in the AMI setting is still known to be an important off-label indication and safety concerns regarding stent thrombosis (ST) and associated major adverse cardiac events (MACE) have been raised because of the systemic thrombotic milieu of the early period of AMI and the combined potentially increased thrombogenicity of the DES itself by causing delayed healing of the coronary endothelium compared with BMSs. [8][9][10] However, recently the KAMIR (Korea AMI Registry) study group reported that the use of DESs in Korean patients with AMI was clinically safe and effective. 11 There is very limited information regarding the angiographic and clinical outcomes among the different DESs in patients with AMI undergoing PCI, especially DESs other than SES and PES. Park et al showed that SES implantation in AMI patients was associated with a reduction of angiographic restenosis at 6 months compared with PES. 12 However, to our knowledge, there are few ongoing studies and no published data comparing SES, PES, and zotarolimus-eluting stents (ZES; Endeavor™) in AMI patients undergoing PCI, so this study was designed to investigate whether there are differences in safety and efficacy, specifically the 6-month angiographic and 1-year clinical outcomes, in patients with AMI undergoing PCI with these 3 different major early-generation DESs.

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Section: Circulation Journal Vol73 December 2009supporting

confidence: 73%

Lack of Clinical Benefit of Improved Angiographic Results With Sirolimus-Eluting Stents Compared With Paclitaxel and Zotarolimus-Eluting Stents in Patients With Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Choi

Rha

Chen

et al. 2009

Circ J

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“…A collaborated paracrinal response from leukocytes, platelets, and VSMCs further augments the proliferation of active VSMCs and migration of more VSMCs from the media, culminating in a sizeable amount of new intimal cell growth (neointimal hyperplasia) over a period of weeks (Ramcharitar et al, 2007). With the passage of time, as the stent surface becomes endothelialized, the cellular and inflammatory response wanes.…”

Section: Biological Mechanismsmentioning

confidence: 99%

Recent advances in drug eluting stents

Puranik

Dawson

Peppas

2013

International Journal of Pharmaceutics

155

114

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One of the most common medical interventions to reopen an occluded vessel is the implantation of a coronary stent. While this method of treatment is effective initially, restenosis, or the re-narrowing of the artery frequently occurs largely due to neointimal hyperplasia of smooth muscle cells. Drug eluting stents were developed in order to provide local, site-specific, controlled release of drugs that can inhibit neointima formation. By implementing a controlled release delivery system it may be possible to control the time release of the pharmacological factors and thus be able to bypass some of the critical events associated with stent hyperplasia and prevent the need for subsequent intervention. However, since the advent of first-generation drug eluting stents, long-term adverse effects have raised concerns regarding their safety. These limitations in safety and efficacy have triggered considerable research in developing biodegradable stents and more potent drug delivery systems. In this review, we shed light on the current state-of-the-art in drug eluting stents, problems related to them and highlight some of the ongoing research in this area.

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“…The stent is coated on the abluminal side with paclitaxel on a durable polymer matrix (PESU), a polysulfone, that permits controlled drug elution 19 27. The unique feature of this stent is the ability to disconnect the stent struts with an angioplasty balloon.…”

Section: Stentysmentioning

confidence: 99%

Bifurcation stenting: current strategies and new devices

Latib

Colombo

Sangiorgi

2008

Heart

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Based on the results of numerous randomised trials, the provisional approach of implanting one stent on the main branch has become the default approach to most bifurcation lesions. However, bifurcation intervention still remains technically challenging. Dedicated bifurcation stents have been designed to specifically treat coronary bifurcations with the aim of dealing with some of the shortcomings of the conventional percutaneous approach to bifurcation intervention. Most of the devices are aimed at facilitating the provisional approach. They are an exciting and innovative technology that may further simplify the management and current approach to bifurcation treatment. Currently, 11 devices are available that have either completed or are currently undergoing First-In-Man trials. The development of more drug-eluting platforms and larger studies with control groups demonstrating their clinical applicability, efficacy and safety are required before they are widely incorporated into daily practice.

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Drug-Eluting Stents, Restenosis and Revascularization

Cited by 14 publications

References 90 publications

Lack of Clinical Benefit of Improved Angiographic Results With Sirolimus-Eluting Stents Compared With Paclitaxel and Zotarolimus-Eluting Stents in Patients With Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Lack of Clinical Benefit of Improved Angiographic Results With Sirolimus-Eluting Stents Compared With Paclitaxel and Zotarolimus-Eluting Stents in Patients With Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Recent advances in drug eluting stents

Bifurcation stenting: current strategies and new devices

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