Drug-eluting stents: caution and concerns for long-term outcome

Coron Artery Dis. 2004 Sep;15(6):313-8. doi: 10.1097/00019501-200409000-00003.

Abstract

Recent publications on drug-eluting stents (DES) report a significant reduction in restenosis rates as compared to bare metal stents in patients mostly with single vessel disease. We have recently observed however, late stent thrombosis following CYPHER DES implantation. The patient developed a hypersensitivity reaction around stent struts limited to the polymer with aneurysmal dilatation and extensive inflammation of the arterial wall in the absence of vascular healing. This incidence promotes a cautionary view and perhaps supports the use of DES only in high-risk patients.

Publication types

  • Review

MeSH terms

  • Animals
  • Coronary Restenosis / drug therapy
  • Coronary Restenosis / etiology*
  • Coronary Restenosis / immunology
  • Device Approval
  • Humans
  • Hypersensitivity / etiology
  • Immunosuppressive Agents / administration & dosage
  • Immunosuppressive Agents / adverse effects*
  • Paclitaxel / administration & dosage
  • Paclitaxel / adverse effects*
  • Polymers / adverse effects*
  • Sirolimus / administration & dosage
  • Sirolimus / adverse effects*
  • Stents / adverse effects*
  • Thrombosis / etiology
  • United States
  • Wound Healing / immunology

Substances

  • Immunosuppressive Agents
  • Polymers
  • Paclitaxel
  • Sirolimus