Early Experiences and Clinical Implications of Drug-Eluting Stents: Part 1

OBJECTIVETo review the pathogenesis of in-stent restenosis and the evolution of drug-eluting stents (DES).DATA SOURCESUsing the search terms sirolimus, paclitaxel, and drug-eluting stents, a literature review was conducted to identify peer-reviewed articles and abstracts in MEDLINE (1966—June 2003). Recent meeting abstracts were accessed through the American Heart Association and the American College of Cardiology Web sites. Citations from available articles were also reviewed for additional references.STUDY SELECTION AND DATA EXTRACTIONPublished reviews and studies showing the effects of in-stent restenosis and drug-coated and -eluting stents were evaluated and reviewed.DATA SYNTHESISCoronary stent implantation is a common form of percutaneous coronary interventions. Approximately 20–30% of patients undergoing stent placement develop restenosis 6 months after the procedure. The primary cause of in-stent restenosis is neointimal proliferation and subsequent accumulation of extracellular matrix, collagen, ...