New frontiers in cardiology: drug-eluting stents: Part I.

Stents represent a major advance in the treatment of obstructive coronary artery disease since the advent of balloon angioplasty. The number of percutaneous coronary interventions performed each year has expanded considerably since the early days. Angioplasty procedures doubled in Europe between 1992 and 1996,1 while an estimated 601 000 percutaneous coronary revascularizations were performed in the United States in 1997.2 Unfortunately, many of these patients develop an exaggerated vascular neointimal proliferation after stenting—namely, in-stent restenosis. Much research has been devoted to the pathophysiology and treatment of in-stent restenosis. As a result of many relentless “trialand-error” endeavors, drug-eluting stents have emerged as a potential solution for restenosis. Drug-eluting stents are coated stents capable of releasing single or multiple bioactive agents into the bloodstream and surrounding tissues. We have been commissioned to present an overview on drug-eluting stents. Acknowledging the challenge of examining such a dynamic and flourishing field, our goals in this 2-part article were to provide a broad perspective of the development of drug-eluting stent technology, to summarize the available clinical data, and to introduce emerging concepts for the understanding and application of this new device in clinical practice.