Key result
Drug-eluting stents aim to reduce restenosis and the need for repeat interventions, although longer-term follow-up in a broader range of patients has revealed some pitfalls.
This 2007 update reviews the mechanisms and available options for drug-eluting stents, noting that while initial results were promising, longer-term follow-up revealed some pitfalls.
Caution advised with drug-eluting stents due to longer-term pitfalls; leaves open optimal patient selection and mitigation strategies.
A nalyst projections for the drug-eluting stent (DES) market estimated that the total number of DES implanted in 2010 would go beyond 4.5 million worldwide. Although the initial results seemed promising, longer-term follow-up in a broader range of patients revealed some pitfalls. ] They are all loaded with drugs that interfere with pathways in the process of inflammation and neointimal proliferation. However, the process of restenosis is a sequence of complex events that has been only partly elucidated over the last 2 decades. 9 Locally acting DES provide the opportunity to interfere with the various mechanisms responsible for each step in the restenotic cascade, and a wide variety of different agents are currently available. Although only sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES) have received US Food and Drug Administration (FDA) approval to date, multiple alternative devices are attempting to find their way to achieve the same goal, namely a reduction of restenosis and the need for repeat interventions.
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Daemen et al. (2007) conducted a review in Restenosis. Drug-eluting stents was evaluated. Drug-eluting stents aim to reduce restenosis and the need for repeat interventions, although longer-term follow-up in a broader range of patients has revealed some pitfalls.
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