Analize asupra noilor generaţii de stenturi coronariene

Abstract

Background: Percutaneous coronary intervention (PCI) with bioabsorbable stents has caused interest because the need for mechanical support for the healing artery is temporary, and beyond the first few months there are potential disadvantages of a permanent metallic prosthesis. This technique was developed over the past 20 years and has only been used in the experiments. At the moment it becomes traditional in many European countries. Drug eluting stents (DES) provide durable strong suppression of neointimal hyperplasia, and reduced the risk of repeated revascularization compared to the implantation of bare metal stents. The persistence of long durable-polymer after completing drug release has been implicated as a potential chronic inflammatory response. DES-based polymers with controlled release of the drug, followed by degradation of the polymer, may improve long-term clinical outcome after percutaneous coronary intervention, with a chronic inflammatory stimulus. These DES were effective and safer stents vs. durable polymer in several randomized clinical trials. Moreover, a computed tomography study showed consistent improvement in coronary artery stent healing after biodegradable DES implantation stents compared with durable-polymer release of sirolimus after 9 months. These stents, according to experts in cardiology and cardiac surgery, should in most cases, replace the current pharmacological coronary stents made of polymers or metal, which are coated with a shell of pharmacological substances that protect patients from the reaction to a foreign body. Conclusions: Since the invention of pharmacological stents has been attempted the idea of an ideal stent without side effects, which are constantly modified and improved to ensure complete healing. But the risk of restenosis and thrombosis has not been completely eliminated.