Therapeutic potential of active stent coating

Heinrich Wieneke*, Axel Schmermund, Clemens von Birgelen, Michael Haude, Raimund Erbel

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

4 Citations (Scopus)

Abstract

Various clinical studies have shown the superiority of stent implantation as compared to conventional balloon angioplasty for the treatment of significant coronary stenosis. However, restenosis remains a major drawback of this interventional technique. Against the background of this serious problem, the concept of stent coating has been developed. In general, coatings can be classified into two types: passive coatings, which only serve as a barrier between the stainless steel, and the tissue and active coatings, which directly interfere with the process of intima proliferation. At this moment, primarily immunosuppressive and cytostatic substances are used as active coatings. Large randomised studies have shown that this novel concept can be successfully implemented into clinical practice. Beside these promising results, studies also revealed potential risks of this new approach. Not only the dosage of the drug but also an optimised kinetic of drug release seem to be essential in preventing restenosis. As with most drugs, the inhibition of neointima proliferation is not restricted to vascular smooth muscle cells but also affects the process of re-endothelialisation, thus we may face a new pitfall of late-stent thrombosis. Although this technique may harbour potential risks, the introduction of stent coating has the potential to dramatically reduce the incidence of restenosis and an exciting chapter in the field of cardiology has been opened.

Original languageEnglish
Pages (from-to)771-779
Number of pages9
JournalExpert Opinion on Investigational Drugs
Volume12
Issue number5
DOIs
Publication statusPublished - 1 May 2003
Externally publishedYes

Keywords

  • Dexamethasone
  • Drug-eluting stent
  • Intima hyperplasia
  • Paclitaxel
  • Restenosis
  • Sirolimus
  • Tacrolimus

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