Drugelutingstenttien

Drugelutingstenttien are coronary stents coated with antiproliferative drugs that are released over time to reduce restenosis after percutaneous coronary intervention. The combination of a metal scaffold and a drug-eluting coating aims to prevent neointimal hyperplasia, the thickening of the vessel wall that can narrow treated arteries.

The drugs used in drugelutingstenttien commonly include sirolimus, everolimus, zotarolimus, and paclitaxel. These agents inhibit smooth muscle cell proliferation and migration, helping to keep the artery open after stent placement. The drug is typically delivered via a polymer coating that controls the release rate over days to weeks. Some newer devices use polymer-free designs or bioresorbable polymers, and there are also polymers that gradually degrade or devices with fully biodegradable scaffolds.

History and generations: the first-generation drugelutingstenttien, approved in the late 1990s, used sirolimus or paclitaxel and raised concerns about polymer-related inflammation and late stent thrombosis. Second-generation stents featured more biocompatible polymers and alternative drug options, with improvements in safety profiles and clinical outcomes. Ongoing innovation includes polymer-free options and devices with different release kinetics or newer antiproliferative drugs.

Indications and risks: they are used to treat de novo coronary artery lesions and complex cases where restenosis risk is high. While they generally reduce the need for repeat revascularization compared with bare-metal stents, they carry risks such as stent thrombosis, especially if antiplatelet therapy is interrupted, and bleeding from dual antiplatelet therapy. Selection of device and therapy duration depends on patient and lesion characteristics.