Drug-eluting stents implantation

Angiolillo DJ, Sabata M, Alfonso F, Macaya C. Candy wrapper effect after drug-eluting stent implantation Deja vu or stumbling over the same stone again. Cath Cardiovasc Interv 2004 61 387-391. 

Eisenstein EL, Anstrom KJ, Kong DF, et al. Clopidogrel use and long-term clinical outcomes after drug-eluting stent implantation. JAMA 2007 297 159-168. 

Costa MA, Sabate M, Angiolillo DJ, et al, Intravascular ultrasound characterization of the "black hole" phenomenon after drug-eluting stent implantation, Am J Cardiol 2006 97(2) 203-206. 

Examples of combination products include drug-eluting stents, implantable insulin pumps, and skin patches that deliver protein therapies. A biological product is a virus, vaccine, therapeutic serum, toxin or antitoxin, blood, blood component or derivative, or allergenic that prevents, treats, or cures diseases or injuries to humans. Biological products include viral vaccines, human blood and plasma, and interferons and erythropoietins. 

Chieffo A, Morici N, Maisano F, et al. Percutaneous treatment with drug-eluting stent implantation versus bypass surgery for unprotected left main stenosis a single-center experience. Circulation 2006 113 2542-7. 

Chieffo A, Park SJ, Valgimigli M, et al. Favorable long-term outcome after drug-eluting stent implantation in nonbifurcation lesions that involve unprotected left main coronary artery. A multicenter registry. Circulation 2007 116 158—62. 

Siqueira, D. A., Abizaid, A. A., Costa, J. d. R., et al. (2007) Late incomplete apposition after drug-eluting stent implantation incidence and potential for adverse clinical outcomes, Eur. 

Kammer RT. Successful clopidogrel desensitization after drug-eluting stent implantation. J Invasive Cardiol 2009 21(3) 134-5. 

Non-STEMI PCI or CABG on individual indication STEMI Primary PCI mode of revascularization PCI with stent implantation Drug-eluting stents should be used PCI Glycoprotein Ilb/IIIa inhibitor indicated in diabetic patients... 

J.A. Ormiston, M.W.I. Webster, G. Armstrong, First-in-human implantation of a fully bioabsorbable drug-eluting stent the BVS poly-L-lactic acid everolimus-eluting coronary stent. Catheter. Cardiovasc. Interv. 69 (2007) 128-131. 

With the aim to overcome the excessive VSMC proliferation observed after BMS implantation, devices able to locally deliver antiproliferative drugs (drug-eluting stents [DESs]) have been developed (Figure 15.21). The most used antiproliferative drugs are sirolimus (Rapamycin ) and paclitaxel (Taxol ). The delivery of these antiproliferative drugs from DES reduces artery restenosis (down to 5%-10% of treated patients [211,212]) more efficiently than BMS. However, DESs did not completely solve the problem [213] as they can trigger unwanted side effects such as stent thrombosis (ST) and delayed restenosis compared to BMS [214,215]. 

Hassan AK, Bergheanu SC, Stijnen T et al. Late stent malap-position risk is higher after drug-eluting stent compared with bare-metal stent implantation and associates with late stent thrombosis. Eur. Heart J. 2010 31 1172-1180. 

Different types of stents are common examples of body implants. A stent is a woven, knitted or braided cylindrical mesh structure made of stainless steel, nitrol or chrome-cobalt alloy that is inserted in a diseased or contracted artery or vein to restore a free blood flow by keeping the vessel open. The stent can be coated with substances to obtain specific properties or for continuous release (a drug-eluting stent) to inhibit cellular growth that may lead to repeated occlusion. 

In summary, the field of drug-eluting stents, which are used for cardiovascular interventions, has come to rely deeply on polymer technology for the development of these implantable devices. Both synthetic and natural polymers are employed to enhance pharmaceutical deUvery and properties of the immunosuppressive drugs. 

Intra-arterial catheters have been used for different objectives, such as the placement of other devices like stents, the delivery of drugs to various targets in the cardiovascular system and the delivery of embolic materials to close arterial-venous fistulas. Drug therapy has also been combined with catheter ablation, pacemakers and cardioverter defibrillators in order to treat arrhythmias. On the other hand, implants for the reconstruction or functional replacement of cardiovascular components have been combined with drugs to prevent thrombosis. Finally, drugs to avoid restenosis have been widely employed in different devices such as drug-eluting stents. 

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