Stent coated

According to ACC/AHA 2007 guidelines, clopidogrel is indicated for up to 12 months in NSTE ACS patients, with a minimum treatment duration of 1 month after placement of a bare-metal stent and 12 months after placement of a sirolimus- or paclitaxel-coated stent. 

Babapulle MN, Eisenberg MJ. Coated stents for the prevention of restenosis Part II. Circulation 2002 106 2859-2866. 

Whelan DM, van der Giessen WJ, Krabbendam SC, van Vliet EA, Verdouw PD, Serruys PW, van Beusekom HM. Biocompatibility of phosphorylcholine coated stents in normal porcine coronary arteries. Heart 2000 83 338-345. 

Farb A, Heller PR Shroff S, et al. Pathological analysis of local delivery of paclitaxel via a polymer-coated stent, Circulation 2001 104 473 79. 

Optimal stent implantation and new antiplatelet therapy have reduced the thrombotic complication after stent implantation, dramatically. However, thrombosis remains a challenge in some lesions and patient subgroups. As an initial and unavoidable event during stent implantation, thrombosis and platelet activation are also involved in the development of neointimal hyperplasia. Stents coated with heparin and other antithrombotic drugs have been demonstrated to decrease thrombotic complications, although their effect on neointimal hyperplasia remains uncertain. As heparin is attached to the stent surface, we divide thromboresistant stents as heparin-coated stents and drug-eluting thromboresistant stents. 

Heparin-coated Palmaz-Schatz, Wiktor, Jostent, BX Velocity, and beStent have been investigated in clinical studies. All studies showed that heparin-coated stents are safe, even in high-risk lesions. When compared with balloon angioplasty, heparin-coated stents could significantly reduce the rate of subacute stent thrombosis and the late restenosis. However, no significant difference of restenosis was observed between the heparin-coated stent and the bare stent control. 

Bickel (44) 2001 NA NA in vitro Bare stent Carbon-coated stent Yes ... 

Inflammatory response after stent implantation plays an important role in the cascade of neointimal formation. A positive correlation between inflammatory reaction and restenosis has been observed (16). Perivasculitis caused by stent deployment also participates in the neointimal formation (17). Corticosteroids, as an anti-inflammatory agent, have been evaluated. Methylprednisolone (MP)-loaded stents with different doses showed a positive dose-related effect on neointimal hyperplasia (18). Furthermore, MP-coated stents showed decreased macrophages at the stented sites (19). In clinic, dexamethasone-coated stents showed an inhibitive effect on neointimal hyperplasia in selected patients (20), although no beneficial effect was observed in a randomized trial compared to bare stents (21). For other type of drugs with anti-inflammatory characteristics, such as ibuprofen, colchicine, aton/astatin, and probucol, no favorable effects on neointimal hyperplasia were observed (18,22,23). 

Kim W, Jeong MH, Hong YJ, et al. The long-term clinical results of a platelet glycoprotein llb/llla receptor blocker (Abciximab Reopro) coated stent in patients with coronary artery disease, Korean J Intern Med 2004 I 9(4) 220-229,... 

Hong YJ, Jeong MH, Kim W, et al. Effect of abciximab-coated stent on in-stent intimal hyperplasia in human coronary arteries. Am J Cardiol 2004 94(8) 1050-1054. 

I I Jeong M, Ahn Y Kang K, et al. ReoPro coated stent inhibits porcine coronary stent thrombus and restenosis [abstr]. Circulation 2000 102(18) ll-666. 

Mir-Akbari H, Sylven C, Lindvall B, etal. phVEGF coated stent reduces restenosis intimal hyperplasia [abstr], Eur heart J 1999 20(suppl) 275,... 

Bickel C, Rupprecht HJ, Darius H, et al. Substantial reduction of platelet adhesion by heparin-coated stents. J Interv Cardiol 2001 14(4) 407-413. 

Ahn YK, Jeong MH, Kim JW, et al. Preventive effects of the heparin-coated stent on restenosis in the porcine model. Catheter Cardiovasc Interv I 999 48(3) 324-330. 

Degertekin M, Sonmez K, Gencbay M, et al. Heparin-coated stent implantation in chronic total occlusion. 3rd International Congress on Coronary Artery Disease, Lyon, France, Oct 2-5, 2000 67. 

Mehran R, Aymong ED, Ashby DT et al. Safety of an aspirin-alone regimen after intracoronary stenting with a heparin-coated stent final results of the HOPE (HEPACOAT and an Antithrombotic Regimen of Aspirin Alone) study. Circulation 2003 108(9) 1078-1083. 

Haude M, Konorza Tp Kalnins U, et al. Heparin-coated stent placement for the treatment of stenoses in small coronary arteries of symptomatic patients. Circulation 2003 ... 

Gupta V Aravamuthan BR, Baskerville S, et al, Reduction of subacute stent thrombosis (SAT) using heparin-coated stents in a large-scale, real world registry. J Invasive Cardiol 2004 ... 

Baron JH, Aggrawal R, de Bono D, GershlickAH, Adsorption and elution of c7E3 Fab from polymer-coated stents in-vitro [abstr], Eur Heart J 1997 I 8(suppl) 503,... 

Aggarwal R, Ireland D, Azrin M, Ezekowitz M, De Bono D, Gershlick A, Antithrombotic potential of polymer-coated stents eluting platelet glycoprotein llb/llla receptor antibody. Circulation 1996 94 331 1-3317. 

Aggarwal R, Ireland D, Azrin M, de Bono D, Gershlik A. Reduction in thrombogenicity of cellulose polymer-coated stents by immobilisation of platelet-targeted urokinase [abstr], J Am Coll Cardiol 1997 29 353A. 

De Scheerder I, Wang K, Wilczek K, et al, Local methylpred-nisolone inhibition of foreign body response to coated intracoronary stents, Coronary Artery Dis 1996 7 161-166. Baker J, Nikolaychik V Zulich A, et al, Fibrin coated stents as depot to deliver RGD peptide inhibit vascular reaction in atherosclerosis rabbit model [abstr], J Am Coll Cardiol I 996 27 197A,... 

De Scheerder I, Wilczek K, Van Dorpe J, et al. Local angiopeptin delivery using coated stents reduces neointimal proliferation in overstretched porcine coronary arteries. J Inves Cardiol 1996 8 215-222. 

Strecker EP Gabelmann A, Boos I, et al. Effect on intimal hyperplasia of dexamethasone released from coated metal stents compared with non-coated stents in canine femoral arteries. Cardiovasc Intervent Radiol 1998 21 487-496,... 

I I New G, MosesJW, Roubin GS, etal. Estrogen-eluting, phos-phorylcholine-coated stent implantation is associated with reduced neointimal formation but no delay in vascular repair in a porcine coronary model. Catheter Cardiovasc Interv 2002 57(2) 266-27l. 

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