Key result
First-generation drug-eluting stents reduced restenosis by >70% in early 1-year reports but were later associated with an increased risk of late and very late stent thrombosis.
First-generation drug-eluting stents were associated with an increased risk of late and very late stent thrombosis, dampening initial enthusiasm.
D rug-eluting stents (DES) were introduced to the coro- nary artery disease treatment market in 2003 with much exuberance and fanfare.With Ͼ70% reduction in restenosis and no apparent safety concerns in 1-year reports from large randomized clinical trials, 1,2 the opportunity for expansion of the technology seemed limitless.Interventional cardiologists responded with confidence and quickly expanded use to a wide array of off-label indications, limited only by initial inventory constraints.3,4 Some even considered DES as a potential therapy for vulnerable lesions or regions that were not yet hemodynamically significant, and there were concerns by hospitals and others that widespread use of these devices for treatment of traditional surgical disease would place cardiac surgery programs in jeopardy.5,6 The realization of an increased risk of late and very late stent thrombosis with the first-generation DES, especially in patients with increased lesion complexity, dampened this enthusiasm.7,
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Donald E. Cutlip (2012) conducted a review in Coronary artery disease. Drug-eluting stents (DES) was evaluated. First-generation drug-eluting stents reduced restenosis by >70% in early 1-year reports but were later associated with an increased risk of late and very late stent thrombosis.
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