Intracoronary stenting and

I 5 Kastrati A, Mehilli J, Schuhlen H, et al. Intracoronary stenting and antithrombotic regimen-rapid eariy action for coronary treatment study investigators. A clinical trial of abciximab in elective percutaneous coronary intervention after pretreatment with clopidogrel. N Engl J Med 2004 350 232-238. 

Intracoronary stenting and antithrombotic regimen is abciximab a superior way to eliminate elevated thrombotic risk in diabetics. Abbreviations MI, myocardial infarction ... 

Kastrati A, Mehilli J, Dirschinger J, et al. Intracoronary Stenting and Angiographic Results Strut Thickness Effect On Restenosis Outcome (ISAR-STEREO) trial. Circulation 2001 103 2816-2821. 

Schuhlen H, Kastrati A, Pache J, et al. Sustained benefit over four years from an initial combined antiplatelet regimen after coronary stent placement in the ISAR trial. Intracoronary Stenting and Antithrombotic Regimen. Am J Cardiol 2001 87 397- 00. 

Kastrati, A., Mehilli, J., Dirschinger, J., Dotzer, F., Schuehlen, H., Neumann, F.J., et al. Intracoronary stenting and angiographic results strut thickness effect on restenosis outcome (ISAR-STEREO) trial. Circulation 103, 2816-2821 (2001)... 

GPIIb/IIIa antagonists have to be administered parenterally. They are currently used prophylactically during intracoronary interventions such as percutaneous transluminal revascularization with balloon angioplasty or intracoronary stenting, as well as to treat acute coronary syndromes like unstable angina and acute myocardial infarction. The main complications... 

Clopidogrel is indicated for prevention of vascular ischaemic events in patients with symptomatic atherosclerosis. It is also used, along with aspirin, for the prevention of thromboembolism after placement of an intracoronary stent. Platelet inhibition can be demonstrated two hours after a single dose of oral clopidogrel, but the onset of action is slow, so that a loading-dose is usually administered. Although rare, severe neutropenia and also thrombotic thrombocytopenic purpura may occur. 

Karrillon GJ, Morice MC, Benveniste E, et al. Intracoronary stent implantation without ultrasound guidance and with replacement of conventional anticoagulation by antiplatelet therapy. 30-day clinical outcome of the French Multicenter Registry. Circulation I 996 94 1 51 9-1 527. 

Urban P Macaya C, Rupprecht HJ, et al. Randomized evaluation of anticoagulation versus antiplatelet therapy after coronary stent implantation in high-risk patients the multicenter aspirin and ticlopidine trial after intracoronary stenting (MATTIS). Circulation 1998 98 2126-2132. 

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. 

The development of novel and powerful antiplatelet agents has improved outcomes after PCI. In the CADILLAC trial, the use of a glycoprotein Ilb-IIIa inhibitor improved outcome in those treated with either balloon angioplasty or an intracoronary stent (21). Similarly, treatment with clopidogrel, a thienopyridine, decreases the incidence of adverse events after PCI (22,23). Neither thienopyridines nor glycoprotein Ilb-IIIa antagonists were available at the time the early trials designed to test the potential clinical efficacy of a combined approach were performed. 

Gibson CM. Primary ioplasty compared with thrombolysis new issues in the era of glycoprotein Ilb/IIIa inhibition and intracoronary stenting. Arm Mem Med (1999) 130, 841-7. 

Pendyala, L., Jabara, R., Robinson, K. et al. 2009. Passive and active polymer coatings for intracoronary stents Novel devices to promote arterial healing. J Interv Cardiol. 22 37 8. 

In the treatment of vascular disease such as arteriosclerosis, intracoronary stent placement is a common adjimct to balloon angioplasty (74). Stents, however, can also cause imdesirable side effects. For example, the continued exposure of a stent to blood can lead to thrombus formation and the presence of a stent in a blood vessel can over time cause the blood vessel wall to weaken creating the potential for arterial rupture or formation of aneurisms. A stent can also become overgrown by tissue after its implantation such that its utility is diminished or eliminated while its continued presence may lead to a variety of complications such as the foregoing. To ameliorate the above situation, stents can be fabricated from materials that are biodegradable and, if desired, bioabsorbable (74). 

---