J Korean Med Assoc.  2008 Apr;51(4):299-305. 10.5124/jkma.2008.51.4.299.

Drug-Eluting Stent: Present and Future

• Park SJ

• KMID: 2185738
• DOI: http://doi.org/10.5124/jkma.2008.51.4.299

Abstract

Since a successful balloon angioplasty of coronary artery stenosis in a patient in 1977, the development of percutaneous coronary intervention was remarkable. The drug-eluting stent reduces the occurrence of in-stent restenosis and the need for subsequent target vessel revascularization, when compared with the bare-metal stent. However, the safety of the drugeluting stent has been called into question because of an apparent increase in late stent thrombosis. With adequate antiplatelet therapy and other optimal medical treatment, the net clinical benefit of the drug-eluting stent may outweigh their risks. The use of drug-eluting stent in the real world is in some cases beyond the indications evaluated in the randomized trials. In a highrisk or complex subset of lesions such as chronic total occlusion, bifurcations, small vessels, long lesions, and saphenous vein grafts, the data appear to be convincing enough to support extended applications. However, in other clinical subsets such as diabetes, multivessel disease, unprotected left main disease, and acute myocardial infarction, more data and longer clinical followups are necessary before implantation of a drug-eluting stent.

Keyword

Drug-eluting stent; Percutaneous coronary intervention; Restenosis

MeSH Terms

Angioplasty, Balloon
Coronary Stenosis
Drug-Eluting Stents
Glycosaminoglycans
Humans
Myocardial Infarction
Percutaneous Coronary Intervention
Saphenous Vein
Stents
Thrombosis
Transplants
Glycosaminoglycans

Figure

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  Figure 1 Drug-eluting stent. Upper panel, mechanism (arrow) of drug release from drug-eluting stent; lower panel, comparison of growth of intimal hyperplasia between bare-metal stent (left lower) and drug-eluting stent (right lower).

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