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Update on Drug-Eluting Stents for Prevention of Restenosis

Cardiac Department, National University Hospital, Singapore

For reprint information contact: Huay-Cheem Tan, FACC Tel: 65 6772 5213 Fax: 65 6777 1684 Email: tanhc{at}nuh.com.sg, Cardiac Department, National University Hospital, Level 3 Main Building, 5 Lower Kent Ridge Road , Singapore 119074.

Despite the success of coronary stent implantations in the last decade, in-stent restenosis due to neointimal hyperplasia remains a problem to overcome. Neointimal hyperplasia is a vascular response to stent injury and mainly consists of proliferation of smooth muscle cells and deposition of extracellular matrix. Recently, local drug delivery has been advocated as a potential strategy to prevent in-stent restenosis. Unprecedented results have been obtained in early clinical studies on sirolimus-eluting and paclitaxel-eluting stents. Trials using various pharmaceutical coatings on different coronary stents are ongoing. More types of drug-eluting stents are expected on the market in the near future. Meanwhile, the evaluation of drug-eluting stents is entering the second phase in which the safety and efficacy in more complex lesion subsets and different clinical presentations are being investigated. Results including cost-benefit analyses are expected to have a tremendous impact on the practice of interventional cardiology in the next decade.