Advances in catheter and stent design have made stent implantation the standard coronary angioplasty procedure. Unfortunately, in-stent restenosis continues to plague this procedure, with the optimum binary restenosis rates reaching ~10% to 20%. In the past few years, it has become clear that in-stent restenosis is largely due to the migration and proliferation of vascular smooth muscle cells to form a neointima. To address this issue, stents coated with drug-delivery vehicles have been developed to deliver antiproliferative therapeutics. Two drugs, rapamycin and taxol, have been the lead compounds for testing the idea of a drug-eluting stent. These drugs have been successful largely because of the solid mechanistic understanding of their effects and extensive preclinical examination. The result of these years of work is that the rapamycin-coated stent entered the US market in April of 2003, and the taxol-coated stent appears poised to follow soon.
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Plaque heterogeneity influences in-stent restenosis following drug-eluting stent implantation: Insights from patient-specific multiscale modelling.
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PoliTo(BIO)Med Lab, Department of Mechanical and Aerospace Engineering, Politecnico di Torino, Turin, Italy.
In-stent restenosis represents a major cause of failure of percutaneous coronary intervention with drug-eluting stent implantation. Computational multiscale models have recently emerged as powerful tools for investigating the mechanobiological mechanisms underlying vascular adaptation processes during in-stent restenosis. However, to date, the interplay between intervention-induced inflammation, drug delivery and drug retention has been under-investigated.
View Article and Find Full Text PDFComposite outcomes of drug-coated balloon using in left main bifurcation lesions: a systematic review.
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Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China.
Background: Left main coronary bifurcation lesions account for 50% of left main coronary artery disease cases. Although a drug-coated balloon (DCB) has the advantages of immediate release of the drug to the arterial wall and no remaining struts, there is no conclusive evidence to support DCB use.
Methods & Results: We conducted a systematic review in compliance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement.
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Department of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China.
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RotarexS rotational atherectomy combined with drug-coated balloon angioplasty for treating femoropopliteal artery in-stent restenosis.
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Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, No. 45, Changchun Street, Beijing, 100053, China.
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