For years, interventional cardiologists have attempted to improve outcomes
for patients with blocked arterial vessels. Some are hailing drug-eluting
stents (DESs) as one of the greatest interventional advances in the past decade.
But others warn that while DESs appear to offer benefit over bare-metal stents,
the hype may be outrunning the science.
Many patients undergo coronary artery bypass graft surgery to relieve
angina and improve long-term survival related to narrowing or blockage of
coronary arteries. Less invasive procedures, percutaneous transluminal coronary
balloon angioplasty, and angioplasty with bare-metal stents attempted to fix
or strengthen the vessels instead of bypassing them. But the desired effects
of balloon angioplasty and other forms of angioplasty are often curtailed
by restenosis. Bare-metal stenting after angioplasty has more durable effects
than angioplasty alone, but researchers are still seeking ways to reduce restenosis,
which occurs about 20% of the time in the clinical setting. Researchers are
also interested in preventing post-procedural myocardial infarction, death,
and the need for target vessel revascularization.
Mitka M. Drug-Eluting Stents Show Promise. JAMA. 2004;291(6):682-683. doi:10.1001/jama.291.6.682