Drug eluting stent in urology

espanolLos estents ureterales liberadores de farmacos (EULF) son los estents mas utilizados en cardiologia intervencionista. Han demostrado que minimizan la tasa de reestenosis despues de su colocacion en los vasos coronarios resolviendo el fenomeno de proliferacion del musculo liso e inflamacion. El efecto de los EULF se atribuye a los farmacos antiproliferativos que recubren el estent y se liberan de una forma controlada. Los farmacos antiproliferativos reducen la reaccion hiperplasica por inhibicion del ciclo celular del musculo liso y su proliferacion. Los estents urologicos son instrumentos importantes en la practica urologica diaria con una variedad de indicaciones para su uso. Sin embargo, su utilizacion se ve dificultada por complicaciones como la infeccion, la incomodidad del paciente, la incrustacion, la migracion y la reaccion hiperplasica. El concepto de estent liberador de farmaco se introdujo en Urologia en un intento por reducir las complicaciones. Los estents liberadores de farmacos para ureter o uretra, tanto polimericos como metalicos se han evaluado en estudios experimentales. La evaluacion clinica de los estents liberadores de farmacos se ha limitado solo a los polimericos, con resultados que requieren mayor investigacion y confirmacion. El desarrollo de estents disenados para el tracto urinario, la seleccion de las substancias adecuadas, combinadas con la investigacion experimental y clinica apropiada ofrecera estents liberadores de farmacos aceptables para la practica urologica. EnglishThe Drug eluting stents (DESs) are the most commonly used stents in interventional cardiology. DESs have been shown to minimize the restenosis rate after stenting the coronary vessels by addressing the phenomena of smooth muscle proliferation and inflammation. The effect of the DESs is attributed to the anti-proliferative drugs which are coated onto the stent and are released in controlled fashion. The anti-proliferative drugs reduce the hyperplastic reaction by inhibiting the smooth muscle cell cycle and their proliferation. Urological stents are important instruments of the everyday urological practice with a variety of indications for their use. Nevertheless, their use is hampered by a number of complications such as infection, patient discomfort, encrustation, migration and hyperplastic reaction. In an attempt to reduce the complications, the concept of DESs was introduced to Urology. DESs for ureteral or urethral as well as polymeric or metal have been evaluated in experimental studies. The clinical evaluation of DESs is limited only to polymeric stent with results that require further investigation and confirmation. The development of stent designed for the urinary tract, the selection of the appropriate substances combined with the appropriate experimental and clinical investigation would provide DESs acceptable for the urological practice.