Vascular stent intracoronary

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. 

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,... 

Chu WW, Toguson R, Pichard AD, et al. Drug-eluting stents versus repeat vascular brachytherapy for patients with recurrent in-stent restenosis after failed intracoronary radiation. J Invasive Cardiol 2005 17( 12) 659—662. 

Hedman M, Hartikainen J, Syvanne M, et al. Safety and feasibility of catheter-based local intracoronary vascular endothelial growth factor gene transfer in the prevention of postangioplasty and in-stent restenosis and in the treatment of chronic myocardial ischemia. Circulation 2003 107 2677-2683. 

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). 

Hedman, M., Hartikainen, J., Syvanne, M., Stjernvall, J., Hedman, A., Kivela, A., Vanninen, E., Mussalo, H., Kauppila, E., Simula, S., Narvanen, O., Rantala, A., Peuhkurinen, K., Nieminen, M. S., Laakso, M., and Yla-Herttuala, S. 2003. Safety and feasibility of catheter-based local intracoronary vascular endothelial growth factor gene transfer in the prevention of postangioplasty and in-stent restenosis and in the treatment of chronic myocardial ischemia—Phase 11 results of the Kuopio Angiogenesis Trial (Kat). Circulation, 107,2677-2683. 

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