Circulation. 2003;107:2274-2279
doi: 10.1161/01.CIR.0000069330.41022.90
doi: 10.1161/01.CIR.0000069330.41022.90
(Circulation. 2003;107:2274.)
© 2003 American Heart Association, Inc.
Clinical Cardiology: New Frontiers |
New Frontiers in Cardiology
Drug-Eluting Stents: Part I
From the Institute Dante Pazzanese of Cardiology, São Paulo, Brazil (J.E.S.); Thoraxcenter, Dijkzigt University Hospital, Rotterdam, the Netherlands (P.W.S.); and University of Florida Health Science Center, Shands Jacksonville, Jacksonville, Fla (M.A.C.).
Correspondence to Prof. J. Eduardo Sousa, MD, PhD, Director of the Institute Dante Pazzanese of Cardiology, Av. Dr Dante Pazzanese, 500 – Ibirapuera, 04012180, São Paulo, Brazil. E-mail jesousa@uol.com.br
Key Words: stents • drugs • restenosis • trials
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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Stents represent a major advance in the treatment of obstructive coronary artery disease since the advent of balloon angioplasty. The number of percutaneous coronary interventions performed each year has expanded considerably since the early days. Angioplasty procedures doubled in Europe between 1992 and 1996,1 while an estimated 601 000 percutaneous coronary revascularizations were performed in the United States in 1997.2 Unfortunately, many of these patients develop an exaggerated vascular neointimal proliferation after stenting—namely, in-stent restenosis. Much research has been devoted to the pathophysiology and treatment of in-stent restenosis. As a result of many relentless "trial-and-error" endeavors, drug-eluting stents have emerged as a potential solution for restenosis. Drug-eluting stents are coated stents capable of releasing single or multiple bioactive agents into the bloodstream and surrounding tissues.
We have been commissioned to present an overview on drug-eluting stents. Acknowledging the challenge of examining such a dynamic and flourishing field, our goals in this 2-part article were to provide a broad perspective of the development of drug-eluting stent technology, to summarize the available clinical data, and to introduce emerging concepts for the understanding and application of this new device in clinical practice.
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Why Drug-Eluting Stents? |
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In 1991, stent use was still facing skepticism because of an unacceptably high (20% to 25%) incidence of thrombotic complications.3 Systemic anticoagulation proved disappointing in reducing the catastrophic consequences of stent thrombosis, such as myocardial infarction and sudden death. Consequently, antithrombotic stent coatings were developed to decrease the inherent thrombogenicity of coronary metallic stents. Some heparin-coated stents have become available for
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