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Drug-eluting coronary stents: insights from preclinical and pathology studies
- Source :
- Nature Reviews Cardiology. 17:37-51
- Publication Year :
- 2019
- Publisher :
- Springer Science and Business Media LLC, 2019.
-
Abstract
- Implantation of drug-eluting stents (DES) is the dominant treatment strategy for patients with symptomatic coronary artery disease. However, the first-generation DES had substantial drawbacks, including delayed healing, local hypersensitivity reactions and neoatherosclerosis, which all led to a steady increase in major adverse cardiovascular events over time. Subsequently, newer-generation DES were introduced with thinner struts, different scaffold designs (to improve deliverability while maintaining radial strength), different durable and biodegradable polymers - and in some cases no polymer (to improve vascular biocompatibility) - and new antiproliferative drug types and doses. Currently, >30 different DES are commercially available in Europe, with fewer available in the USA but with many new entrants coming onto the US market in the next few years. Never before have cardiologists been faced with so many choices of stent, each with its own unique design. In this Review, we detail preclinical and pathology studies for each stent design, examining thromboresistance, speed of neointimal coverage and completeness of healing, including endothelialization. We conclude by discussing how these design characteristics might affect the potential for shortening the minimum duration of dual antiplatelet therapy needed after coronary intervention.
- Subjects :
- 0301 basic medicine
Drug
Pathology
medicine.medical_specialty
media_common.quotation_subject
medicine.medical_treatment
Coronary Artery Disease
030204 cardiovascular system & hematology
Prosthesis Design
Design characteristics
Coronary artery disease
03 medical and health sciences
Percutaneous Coronary Intervention
0302 clinical medicine
Risk Factors
Neointima
Animals
Humans
Medicine
Cell Proliferation
media_common
Wound Healing
business.industry
Stent
Drug-Eluting Stents
medicine.disease
Coronary Vessels
Treatment Outcome
030104 developmental biology
Treatment strategy
New entrants
Cardiology and Cardiovascular Medicine
business
Stent design
Delayed healing
Platelet Aggregation Inhibitors
Subjects
Details
- ISSN :
- 17595010 and 17595002
- Volume :
- 17
- Database :
- OpenAIRE
- Journal :
- Nature Reviews Cardiology
- Accession number :
- edsair.doi.dedup.....0ddc16cd9e1db0a21da11a84b253ec55