The future of drug eluting stents

Rafik R Anis ¹ and Karl R Karsch ^2*

¹ Bristol Heart Institute, United Kingdom
² Bristol Royal Infirmary, United Kingdom

^* To whom correspondence should be addressed. E-mail: k.r.karsch{at}bristol.ac.uk.

Accepted 14 August 2005

Abstract

In-stent restenosis (ISR) is the major drawback of percutaneous coronary interventions, occurring in 10-40% of the patients.[1] Drug-eluting stents (DES) are successful in a large majority of cases in preventing restenosis for the first year following implantation. Recently, new stents have emerged which are loaded with anti-inflammatory, anti-migratory, anti-proliferative or pro-healing drugs. These drugs are supposed to inhibit inflammation and neointimal growth and subsequently ISR. One problem with current DES is that, as many as 40% of patients receiving DES require very long stented segments in order to provide adequate coverage. Further when the coronary tree is excessively tortuous or heavily calcified delivery of long DES is technically difficult.

Newer stent designs and innovative ideas of drug delivery, as well as newer drugs are likely to emerge to prevent ISR, however results with new DES are available in only limited number of cases. The future of DES lies in innovation of better[1] stents with new stent design,[2] polymers with emerging of biological polymers and biological biodisolvable stent coating and[3] new drugs.

Keywords: drug-eluting stents

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