Drug Eluting Stents in Interventional Cardiology - Current Evidence and Emerging Uses

2005 ◽  
Vol 5 (4) ◽  
pp. 313-321 ◽  
Author(s):  
N. Swanson ◽  
A. Gershlick
Keyword(s):  
Interventional Cardiology ◽  
Current Evidence ◽  
Drug Eluting Stents ◽  
Drug Eluting

scholarly journals Impact of Routine Use of Drug-eluting Stents in Contemporary Interventional Cardiology at a Tertiary Center: One-decade Experience of the DESIRE Registry

2012 ◽  
Vol 20 (4) ◽  
pp. 355-360
Author(s):  
J. Ribamar Costa Junior ◽  
Amanda G.M.R. Sousa ◽  
Adriana Costa Moreira ◽  
Ricardo A. da Costa ◽  
Galo Maldonado ◽  
...  
Keyword(s):  
Interventional Cardiology ◽  
Drug Eluting Stents ◽  
Tertiary Center ◽  
Drug Eluting

Femtosecond Laser Nanotexturing of Drug-Eluting Stents

2012 ◽  
Vol 134 (6) ◽  
Author(s):  
Rajeev Nair ◽  
Vaelan Molian ◽  
Pal Molian
Keyword(s):  
Femtosecond Laser ◽  
Cost Effective ◽  
Interventional Cardiology ◽  
Drug Eluting Stents ◽  
Potential Cost ◽  
Polymer Carrier ◽  
Stent Restenosis ◽  
Drug Eluting ◽  
In Stent Restenosis

Drug-eluting stents (DES) have profoundly affected the field of interventional cardiology by dramatically reducing the problem of in-stent restenosis. However, the adverse, long-term, thrombosis raises the questions on the safety profile of DES. Femtosecond pulsed laser nanotexturing of metallic stents was performed to minimize thrombosis by improving three fundamental characteristics of DES: (1) increase the availability of drug for elution; (2) enhance the adhesion between stent and drug; and (3) minimize and, if possible, eliminate the polymer carrier. Results of laser-induced nanoprotrusion/drug interactions confirmed these benefits and indicated that femtosecond laser nanotexturing is a potential cost-effective solution for improving the performance and safety of DES while eliminating the need for postfinishing operations.

Controlled Release of Aspirin from SiO2-PEG Hybrid Coating on 316Lss Substrate for the Preparation of Drug Eluting Stents

2011 ◽  
Vol 287-290 ◽  
pp. 1956-1959 ◽  
Author(s):  
Min Kun Jian ◽  
Wen Ping Chen ◽  
Miao Feng ◽  
Hong Bing Zhan
Keyword(s):  
Steel Substrate ◽  
Sol Gel ◽  
Interventional Cardiology ◽  
Polymer Coatings ◽  
Silica Matrix ◽  
Drug Eluting Stents ◽  
Burst Release ◽  
Coating Materials ◽  
Inorganic Coatings ◽  
Drug Eluting

Despite drug eluting stents (DESs) have revolutionized the interventional cardiology over the past decade since the first DES became commercially available nearly a decade ago, burst release of loaded drugs and late thrombosis caused by polymer coatings of the stents are high concerned. In this situation, inorganic coatings, such as silica-based hybrid materials, have aroused researcher’s interest. In this study, aspirin (ASA) was incorporated into the sol-gel derived silica matrix with polyethylene glycol (PEG) as an organic modifier to improve the flexibility and extensibility of the inorganic matrices. We also used L-3,4-dihydroxyphenylalanine (L-DOPA) as a bio-adhesive reagent to enhance interface adhesion between the coating materials and the 316L stainless steel substrate. The results show that the introduction of D-LOPA can greatly improve the coating quality by enhancement of uniformity and adhesion. The loading ASA was slowly released from the coatings and burst release was effectively inhibited owing to the encapsulation of ASA molecules in the silica-PEG matrices.

scholarly journals Use and Misuse of Multivariable Approaches in Interventional Cardiology Studies on Drug-Eluting Stents: A Systematic Review

2012 ◽  
Vol 25 (6) ◽  
pp. 611-621 ◽  
Author(s):  
FABRIZIO D’ASCENZO ◽  
ERIKA CAVALLERO ◽  
GIUSEPPE BIONDI-ZOCCAI ◽  
CLAUDIO MORETTI ◽  
PIERLUIGI OMEDÈ ◽  
...  
Keyword(s):  
Systematic Review ◽  
Interventional Cardiology ◽  
Drug Eluting Stents ◽  
Drug Eluting

Abstract P108: Assessing Utility of Drug-Eluting Stents in Coronary Patients Aged 85 Years and Older

2011 ◽  
Vol 4 (suppl_2) ◽  
Author(s):  
Daniel E Forman ◽  
Samip Vasaiwala ◽  
Traecy S Silbaugh ◽  
Ann Lovett ◽  
Sharon-Lise T Normand ◽  
...  
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Mortality Rates ◽  
Vital Statistics ◽  
Current Evidence ◽  
Drug Eluting Stents ◽  
Entire Cohort ◽  
Target Vessel Revascularization ◽  
Drug Eluting

Background: Very old (VO) adults (≥85 years) are intrinsically susceptible to coronary heart disease (CHD) and are often treated with coronary stents. While current evidence supports use of drug-eluting stents (DES), generalizability to VO remains controversial, especially given high age-associated bleeding risks from long-term dual antiplatelet therapy. Methods: We identified all VO CHD patients who received stents between April 1, 2003 and September 30, 2006 at all non-federal hospitals in Massachusetts (MA) (N=1619), and completed 2-year follow-up on the entire cohort. Patients were classified as DES-treated if stents were all drug-eluting and BMS-treated if stents were all bare-metal (those receiving DES and BMS were excluded). Mortality rates were determined from vital statistics records. New myocardial infarction (MI) and subsequent bleeding (requiring hospitalization) were determined using ICD-9 codes. Repeat target vessel revascularization (TVR) was determined from the MA database. Risk-adjusted cumulative incidence was estimated using propensity score matching based on 57 clinical, procedural, hospital, and insurance variables. Results: During the study period, 1145 and 474 VO patients received DES and BMS respectively. Unadjusted 2-year mortality rates were 23.8% vs. 35.0% (DES vs. BMS, p<0.0001). Risk-adjusted (propensity score matching [665 DES:343 BMS]) 2-year DES vs. BMS rates were 25.4% vs. 32.4% (hazard ratio [HR] 0.69, 95% confidence interval [CI] 0.51, 0.93; p=0.01) for mortality and 9.8 vs.16.9% (HR 0.51, 95% CI 0.35, 0.76; p=0.001) for MI. Risk-adjusted 2-year rates of bleeding (13.6% vs. 12.5%, HR 1.08, 95% CI 0.73, 1.59; p=0.72) and TVR (5.7% vs. 8.7%, HR 0.62, 95% CI 0.38, 1.02; p=0.06) were similar in patients treated with DES vs. BMS. Conclusions: In a large, unrestricted, state dataset of VO CHD patients with mandated follow-up, DES were associated with reduced 2-year mortality and MI compared with a matched BMS subset, without an increased hazard of bleeding.

scholarly journals Stents in interventional cardiology

Medicina ◽  
2007 ◽  
Vol 43 (3) ◽  
pp. 183 ◽  
Author(s):  
Virgilijus Grinius ◽  
Ramūnas Navickas ◽  
Ramūnas Unikas
Keyword(s):  
Stent Thrombosis ◽  
Coronary Angioplasty ◽  
Interventional Cardiology ◽  
Percutaneous Transluminal Coronary Angioplasty ◽  
Coronary Stenting ◽  
Drug Eluting Stents ◽  
Restenosis Rate ◽  
Drug Eluting ◽  
Transluminal Coronary Angioplasty ◽  
Percutaneous Transluminal

Since the first percutaneous transluminal coronary angioplasty performed by A. Gruentzig in 1977, percutaneous coronary interventions have become the most important treatment modality for coronary heart disease. Coronary angioplasty carried a significant risk of coronary flow-limiting dissections and restenosis during the first six months following the procedure. Two main studies comparing percutaneous transluminal coronary angioplasty and coronary stenting (STRESS and BENESTENT) performed in 1994 showed a significant reduction in restenosis rate using stents. Thus, until now stents are the most widely used devices for coronary intervention despite two problems: subacute stent thrombosis (1–2%) and still high restenosis rate (5–40%). Subacute stent thrombosis occurs within the first month after stent placement and can be prevented using the double antiplatelet regimen with aspirin and clopidogrel. Some risk of subacute thrombosis remains beyond the first month when drug-eluting stents are used. This requires prolonged antiplatelet therapy. Drugeluting stents are the most significant innovation in interventional cardiology. They can reduce the incidence of restenosis in native stable coronary arteries to 3–5%. However, the long-term studies comparing bare-metal stents and drug-eluting stents did not show any significant differences in the rate of major adverse cardiac events (death, myocardial infarction), especially in patients with diabetes after the treatment of bifurcational lesions. According to proposed recommendations, drug-eluting stents should be used in small vessels, restenotic lesions, and in saphenous vein grafts. Despite some disadvantages, the results of coronary stenting using drugeluting stents continue to improve.

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