Circulation. 2002;106:2859-2866
doi: 10.1161/01.CIR.0000038984.30279.89
doi: 10.1161/01.CIR.0000038984.30279.89
(Circulation. 2002;106:2859.)
© 2002 American Heart Association, Inc.
Special Review |
Coated Stents for the Prevention of Restenosis: Part II
From the Division of Cardiology, Montreal General Hospital/McGill University (M.N.B.), and the Divisions of Cardiology and Clinical Epidemiology, Jewish General Hospital/McGill University (M.J.E.), Montreal, Quebec, Canada.
Correspondence to Mark J. Eisenberg, MD, MPH, Associate Professor of Medicine, Divisions of Cardiology and Clinical Epidemiology, Jewish General Hospital/McGill University, 3755 Cote-St-Catherine Rd, Suite A-118, Montreal, Quebec H3T 1E2, Canada. E-mail marke@epid.jgh.mcgill.ca
Key Words: restenosis • stents • drugs
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
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Introduction |
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This is the second part of a 2-part article that reviews the literature on coated stents and their effects on in-stent restenosis after percutaneous coronary intervention (PCI). Part I of this review discussed the pathophysiology of in-stent restenosis, specific stent coatings, and animal studies investigating coated stents. Part II discusses nonrandomized studies and clinical trials in humans. Studies in humans have examined stents coated with biocompatible materials and drug-eluting stents. Complications and controversies associated with this new technology are also addressed.
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Human Studies |
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The risk of developing in-stent restenosis is related to a variety of factors, both clinical and procedural.1–7 On the basis of these risk factors, patients enrolled in both nonrandomized studies and clinical trials have been classified as having a high, intermediate, or low risk of restenosis. Therefore, the binary restenosis rates (>50% diameter stenosis angiographically) and major adverse cardiac event (MACE) rates in human studies vary greatly depending on the overall risk profile of patients enrolled in these studies.
Non-Randomized Studies
Stents Coated with Biocompatible Materials
The biocompatibility of stents coated with several materials, including carbon, gold, silicon carbide, and phosphorylcholine, has been investigated in humans. The Carbostent (Sorin Biomedica Cardio) is a metal stent coated with a carbon film that is thought to be less thrombogenic than uncoated steel stents.8 Antoniucci et al9 investigated the long-term biocompatibility of the Carbostent in a group of 112 patients with an intermediate risk of developing restenosis. Six-month follow-up revealed low MACE and restenosis rates of 12% and 11%, respectively. A second study in another group of 112 patients
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