Drug-eluting Stents

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  • Coronary stents have evolved in order to avoid both restenosis and thrombosis.

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    Coronary stents have evolved in order to avoid both restenosis and thrombosis.

    Drug-eluting stents were developed in order to provide local, site-specific, controlled release of drugs that can inhibit neointima formation. By implementing a controlled release delivery system it may be possible to control the time release of the pharmacological factors and thus be able to bypass some of the critical events associated with stent hyperplasia and prevent the need for subsequent intervention.

    Second-generation everolimus-eluting stents have proven to have superior outcomes compared with first-generation paclitaxel- and sirolimus-eluting stents. The second-generation zotarolimus-eluting stents appear to be similar to the everolimus-eluting stents, though with a lesser degree of evidence. Stents with biodegradable polymers have not been shown to be superior to everolimus-eluting stents. Bioabsorbable scaffolds have not demonstrated better outcomes than current standard treatment with second-generation drug-eluting stents, but have showed a concerning signal of late and very late stent thrombosis. Everolimus-eluting stents have the most favourable outcomes in terms of safety and efficacy in patients undergoing percutaneous coronary intervention.

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