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Biodegradable drug-eluting stents: promises and pitfalls

2008; Elsevier BV; Volume: 371; Issue: 9616 Linguagem: Inglês

10.1016/s0140-6736(08)60389-x

1474-547X

Carlo Di Mario, Giuseppe Ferrante,

Antiplatelet Therapy and Cardiovascular Diseases

The main impetus for the development of biodegradable stents was the high incidence of subacute stent thrombosis. In the late 1990s, the Igaki–Tamai stent, a bioabsorbable stent made of a high-molecular-weight polymer of L-lactic acid, was implanted in 15 patients (25 stents), with a re-stenosis rate at 6 months as low as 10·5%. 1 Tamai H Igaki K Kyo E et al. Initial and 6-month results of biodegradable poly-l-lactic acid coronary stents in humans. Circulation. 2000; 102: 399-404 Crossref PubMed Scopus (709) Google Scholar However, when use of high-pressure deployment of stents and routine aspirin and clopidogrel substantially reduced thrombotic events, results of this first clinical experience rapidly fell into oblivion. The recent resurgence of interest is undoubtedly due to the fear of late stent thrombosis after implantation of drug-eluting stents. 2 McFadden EP Stabile E Regar E et al. Late thrombosis in drug-eluting coronary stents after discontinuation of antiplatelet therapy. Lancet. 2004; 364: 1519-1521 Summary Full Text Full Text PDF PubMed Scopus (1330) Google Scholar , 3 Jaffe R Strauss BH Late and very late thrombosis of drug-eluting stents: evolving concepts and perspectives. J Am Coll Cardiol. 2007; 50: 119-127 Summary Full Text Full Text PDF PubMed Scopus (112) Google Scholar A bioabsorbable everolimus-eluting coronary stent system for patients with single de-novo coronary artery lesions (ABSORB): a prospective open-label trialThis study shows the feasibility of implantation of the bioabsorbable everolimus-eluting stent, with an acceptable in-stent late loss, minimal intrastent neointimal hyperplasia, and a low stent area obstruction. Full-Text PDF