HEART REVIEW

The future of drug eluting stents

R R Anis, K R Karsch

Correspondence to:
Professor Karl R Karsch
Bristol Heart Institute, University of Bristol, Bristol BS2 8HW, UK; k.r.karsch{at}bristol.ac.uk

In-stent restenosis (ISR) is the major drawback of percutaneous coronary interventions, occurring in 10–40% of patients. Drug eluting stents (DES) are successful in a large majority of patients in preventing restenosis for the first year after implantation. Recently, new stents have emerged that are loaded with anti-inflammatory, antimigratory, antiproliferative, or pro-healing drugs. These drugs are supposed to inhibit inflammation and neointimal growth and subsequently ISR. The future of DES lies in the development of better stents with new stent designs, better polymers including biological polymers and biological biodissolvable stent coatings, and new, better drugs.

Abbreviations: DES, drug eluting stents; ENDEAVOR, randomised, controlled trial of the Medtronic Endeavor drug (ABT-578) eluting coronary stent system versus the Taxus paclitaxel-eluting coronary stent system in de novo native coronary artery lesions; EuroSTAR, European collaborators registry on stent-graft techniques for abdominal aortic aneurysm repair; ISR, in-stent restenosis; PC, phosphorylcholine coated; PCL, poly( caprolactone); PLGA, poly(DL-lactide-co-glycolide); RAVEL, randomized study with sirolimus coated BX velocity balloon expandable stent in the treatment of patients with de novo native coronary lesions; SIRIUS, sirolimus eluting balloon expandable stent in the treatment of patients with de novo native coronary artery lesions; TAXUS, treatment of de novo coronary disease with a single paclitaxel eluting stent; VEGF-2, vascular endothelial growth factor 2

Keywords: drug eluting stents; review

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