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Drug-eluting stents: to use or not to use – that is the question!
  1. Matthias E. Pfisterer (mpfisterer{at}uhbs.ch)
  1. University Hospital Basel, Switzerland

    Abstract

    The boom of drug-eluting stents (DES) which was noted also in the UK despite initial restrictions by NICE was stopped by first reports about an increased risk of late stent thrombosis and related cardiac death or myocardial infarction (MI) several months to years after DES implantation (1,2).Although this finding was confirmed in many analyses (3-5), it’s clinical relevance remained disputed: since it was not associated with increased rates of death or MI (3,6), it was considered “irrelevant” by many, whereas others - like NICE - were impressed by the severity of its consequences and opted to ban DES entirely. In July 2007, NICE released a new draft guidance on the use of DES stating that “DES are not recommended for use in percutaneous coronary intervention in patients with coronary artery disease (CAD)”. This recommendation led to extensive debates among interventional cardiologists, other health care professionals and industry and to new long-term data and met-analyses.

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