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Developments in coronary artery stenting: Primum non nocere.
MedLine Citation:
PMID:  21346701     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
The occurrence of restenosis and acute vessel closure postballoon angioplasty was the driving force for the introduction of coronary artery stenting in the 1980s. Although the first generation of coronary artery stents were highly valuable and efficient in scaffolding (non-)threatened coronary vessels, they proved to be associated with iatrogenic side effects such as in-stent neointimal hyperplasia. The efforts to tackle these side-effects eventually lead to the most significant progress within the field of interventional cardiology in the past decennium, namely drug-eluting stents (DES). Analysts estimate that the total amount of DES implantations worldwide will be more than 5 million this year. Although this worldwide increase in percutaneous coronary interventions (PCI) is impressive, some pitfalls such as the incidence of neointimal hyperplasia, stent fracture and a local hypersensitivity reaction against the polymer coating are worrisome. According to critics, the possible causal relationship with higher rates of very-late stent thrombosis could be a ticking time bomb. These concerns paved the way for the development of novel stents, ranging from DES with biodegradable polymer coating to completely biodegradable stents. Like all progress in medical interventions, it is essential to not harm the patient throughout this complex evolvement process of coronary stents. The current review not only discusses the benefits and safety issues associated with currently utilized coronary stents but in particular highlights novel coronary stents that are being investigated in (pre-)clinical trials at this moment.
Authors:
C Simsek; P W Serruys
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Panminerva medica     Volume:  53     ISSN:  1827-1898     ISO Abbreviation:  Panminerva Med     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0421110     Medline TA:  Panminerva Med     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  19-30     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Thoraxcenter Erasmus Medical Center, Rotterdam, The Netherlands - p.w.j.c.serruys@erasmusmc.nl.
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