New Interventions In Cardiology

摘要

Since the advent of coronary angioplasty in 1977 by Dr Andreas Gruentzig, which revolutionized the treatment of coronary artery disease, the technique of percutaneous coronary intervention has undergone tremendous transformation beyond the wildest imagination of many. From plain old balloon angioplasty to the development of atherectomy (laser, directional, rotating) devices and coronary stents, medicine has never witnessed a field that exhibits such dynamism and innovation. Coronary stent has emerged over the years to be the established platform strategy for interventional procedures performed in all modern day cardiac catheterization laboratories. Unfortunately, many of these patients developed an exaggerated vascular neointimal proliferation after stenting, namely, in-stent restenosis (ISR). The incidence can vary from 20% to 40%, depending on clinical and anatomic factors. Mechanical approaches to treat 1ST? have proved too simplistic and ineffective. The concept of using stents as vehicles for prolonged and sufficient intramural drug delivery to reduce ISR is appealing. Stents represent an ideal platform for local drug delivery because of their permanent scaffolding properties, which prevent vessel recoil and negative remodeling. They can also serve as reservoir of drugs that can release drugs from various coatings at specified time intervals. In fact, the development of drug-eluting stents (DES) has been a true story of an outstanding bioengineering feat.