Stent development and local drug delivery.

摘要: Stent implantation has become the new standard angioplasty procedure. In-stent re-stenosis remains major limitation of coronary stenting. Re-stenosis is related to patient-, lesion- and procedure-specific factors. Patient-specific factors can not be influenced any extent. Procedure-specific are affected by technique stent characteristics. Design material influence vascular injury humoral cellular response. Radiation been shown have inhibitory effects on smooth muscle cell growth neo-intima formation, but in clinical trials outcome hampered at edges radioactive ('candy wrapper'). New approaches target pharmacological modulation local biology administration drugs. This allows for drug application precise site time vessel injury. Systemic release minimal this may reduce risk toxicity. The delivery vehicle must fulfil pharmacological, pharmacokinetic mechanical requirements eluting degradable matrices seems a possible solution. Numerous agents with antiproliferative properties currently under investigation, e.g. actinomycin D, rapamycin or paclitaxel. Another approach stents made biodegradable materials as an alternative metallic stents. Their potential long-term complications, such in-stent inaccessibility lesion surgical revascularization, needs assessed. Current investigational devices line (pre)clinical investigation discussed detail. Currently, there little experimental, only preliminary clinical, understanding acute drug-eluting arteries. benefit these still proven.