Percutaneous coronary interventions (PCI) are a valuable addition to treatment regimens in modern cardiology.
1-3 The use of intracoronary metallic stents has improved results over balloon dilatation alone and has become standard care for patients undergoing PCI.
4 However, in-stent restenosis, leading to recurrence of symptoms, has been the major drawback of bare metal stents (BMS).
5 Drug-eluting stents (DES) were introduced in an attempt to overcome this problem and, due to the improved effectiveness in preventing restenosis, DES implantation has rapidly grown to up to 80% of cases in some countries.
6 However, recently there have been concerns about their long-term safety,
7 due to an increase in late stent thrombosis, possibly linked to delayed endothelialisation of the stent struts. Delayed endothelial cell growth is due to a non-selective inhibitory action of the drug on targeting both smooth muscle cell proliferation and endothelial cell regeneration.
8 Moreover, DES definitely increases the cost of PCI when compared with BMS and debate is ongoing over the long-term cost-effectiveness of these devices.
9 …
