Recent Developments in Drug-Eluting Coronary Stents
Banu Sahin Yildiz,
Mustafa Ozan Gursoy,
The interventional treatment of coronary artery disease was introduced in 1970`s by Andreas Grüntzig. The
initial treatment strategy with plain old balloon angioplasty (POBA) was associated with high restenosis rates. The
introduction of coronary stents, especially drug-eluting stents (DES) in 2002 has improved the results by lowering the rate
of in-stent restenosis from 20-40% in the era of bare-metal stent (BMS) to 6-8%. However, in 2006 with the observation
of late stent thrombosis the reputations of DES have decreased. However, improvements in stent design especially antiproliferative
agents, polymeric agents as well as stent platforms improved newer generation DES. In controlled trials as
well as registries the use of second-generation DES as compared to bare-metal stents (BMS) was associated with better
clinical and angiographic results. A further development of these stents with use of biodegradable polymers, polymer-free
stents, and biodegradable stents on the basis of poly L-lactide (PLLA) or magnesium resulted in third-generation DES and
has been evaluated in preclinical and first clinical trials. However, to date, there is a lack of data comparing these thirdgeneration
DES with first- and second-generatrion DES in a large scale.
Keywords: Bioabsorbable, drug-eluting stent, everolimus, next-generation, stent thrombosis, zotarolimus.
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