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Interventional Pharmacology: Stent Based Drug Delivery, Local Drug Delivery Management of Patients Before and After PCI

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PanVascular Medicine

Abstract

Percutaneous coronary intervention (PCI) has made remarkable advances over the past 25 years. The development of bare-metal stents (BMS) has allowed an effective prevention of the risk for abrupt closure of the artery and has significantly improved long-term results but introduced a novel pathobiologic process, defined as in-stent restenosis (ISR) .

The introduction of drug-eluting stents (DES) in PCI was a major innovative advancement in interventional cardiology. DES dramatically reduced the ISR rate and guarantee improved clinical outcomes in all subgroups of patients in both randomized clinical trials and real-world practice.

Continuing improvement in drug-delivery stent technologies in terms of bioabsorbable scaffolds and polymers and new drugs along with gradual reduction in cost would maintain DES as the most appropriate current invasive treatment for coronary artery disease.

The hope is that a healed, normally functioning vessel, free of foreign body and restenosis, will be free from the risk of late stent thrombosis. Only time will tell if this dream will come true.

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Abbreviations

Percutaneous coronary intervention (PCI):

Catheter-based approach to treat hemodynamically relevant coronary artery disease.

Stent:

Metalic or polymer scaffold designed to prevent collaps or recoil of an artery following mechanical intervention.

BMS:

Bare-metal stent

DES:

Drug-eluting stent

EES:

Everolimus-eluting stent

ISR:

In-stent restenosis

PCI:

Percutaneous coronary intervention

PES:

Paclitaxel-eluting stent

PTCA:

Percutaneous transluminal coronary angioplasty

SES:

Sirolimus-eluting stent

ST:

Stent thrombosis

TVF:

Target vessel failure

TVR:

Target vessel revascularization

ZES:

Zotarolimus-eluting stent

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Further Reading

  • Price MJ (2013) Coronary stenting: a companion to Topol’s textbook of interventional cardiology. Saunders & Co., Philadelphia

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Authors and Affiliations

  1. Cardiovascular Research Foundation, New York, NY, USA

    Elias A. Sanidas

  2. Columbia University Medical Center and New York Presbyterian Hospital, New York, NY, USA

    Spyretta Golemati

  3. The Icahn School of Medicine at Mount Sinai, New York, NY, USA

    George D. Dangas

  4. Cardiovascular Innovation, Mount Sinai Medical Center, New York, NY, USA

    George D. Dangas

Authors
  1. Elias A. Sanidas
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  2. Spyretta Golemati
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  3. George D. Dangas
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Corresponding author

Correspondence to George D. Dangas .

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Editors and Affiliations

  1. Division of Cardiovascular Disease Department of Internal Medicine, Health Care Center Bitterfeld, Bitterfeld-Wolfen, Germany

    Peter Lanzer

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Sanidas, E.A., Golemati, S., Dangas, G.D. (2015). Interventional Pharmacology: Stent Based Drug Delivery, Local Drug Delivery Management of Patients Before and After PCI. In: Lanzer, P. (eds) PanVascular Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-37078-6_221

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