Drug-eluting stents: insights into safety and indications

rug-eluting stents have attracted considerable attention since their commercial approval more than 5 years ago when they were considered by some as one of the most important breakthroughs in the history of cardiovascular medicine. Different drug-elut-ing stents, with different drugs, different polymers, and different elution kinetics have been introduced. These drug-eluting stents behave differently with different cell cycle inhibition. In particular, drug elution kinetics and drug delivery homogeneity may play a role in the rate of vessel healing. The sirolimus-eluting stent (CYPHER, Cordis Corporation, USA) delivers the entire drug in the first 60 to 90 days. There is no drug left on the stent after this initial elution phase. In contrast, the slow-re-lease, polymer-based paclitaxel-eluting stent (TAXUS, Boston Scientific, USA) elutes only about 10% of the active drug in the first 30 to 60 days. The remaining 90% of the taxol content on the stent is permanently sequestered, in the polymer. It is more likely that this