Why is paclitaxel used in stents?
Paclitaxel is released from the balloon or stent to prevent scar tissue formation in the blood vessel that can re-obstruct the artery (restenosis).
Which type of stent is best?
In general, drug-eluting stents are less likely to cause restenosis than are bare-metal stents. A drug-eluting stent is the most common type of stent used to treat a blockage of the heart arteries.
Why do drug-eluting stents cause thrombosis?
The Un-Healed Stent Following this line of reasoning, months after implantation a drug-eluting stent is effectively denuded. The drug coating is depleted and there is no new tissue coating the stent struts. As a result, blood flows directly over a “bare” surface, a perfect set-up for thrombus formation.
Do drug-eluting stents dissolve?
The Absorb dissolving heart stent is the first and only device of its kind – a coronary drug-eluting stent that dissolves completely in the body over time. Absorb treats coronary artery disease by keeping the diseased vessel open to restore blood flow, but then dissolves and disappears after the artery is healed.
How common is stent thrombosis?
Stent Thrombosis Background The most feared complication related to coronary stent placement is stent thrombosis, which, although fortunately rare (occurring in ≈0.5% to 1% of patients within 1 year), most commonly presents as an acute myocardial infarction (MI).
Why does stent thrombosis occur?
The primary factors contributing to stent thrombosis are inadequate stent deployment, incomplete stent apposition, residual stenosis, unrecognized dissection impairing blood flow, and noncompliance with dual antiplatelet therapy (DAPT). Noncompliance with DAPT is the most common cause of stent thrombosis.
What are the current rates of stent thrombosis?
Current clinical registries and randomized trials with broad inclusion criteria show rates of ST at or <1% after 1 year and ∼0.2–0.4% per year thereafter; rates of clinical ISR are 5% respectively. Angiographic surveillance studies in large cohorts show rates of angiographic ISR of ∼10% with new-generation DES.
How does stent implantation affect the rate of restenosis?
Moreover, the additional advantage in terms of mechanical strength with stent implantation resulted in greater acute gain in luminal calibre and negation of the effects of vessel recoil and constrictive remodelling. This translated into a significantly lower rate of subsequent restenosis.
What are the keywords for stent thrombosis?
Keywords: Bioresorbable stents, Coronary artery disease, Drug-eluting stents, In-stent restenosis, Neoatherosclerosis, Stent thrombosis Historical background
How is neoatherosclerotic change related to stent failure?
The advent of high-resolution intracoronary imaging has shown that in many cases of late stent failure neoatherosclerotic change within the stented segment represents a final common pathway for both thrombotic and restenotic events. In future, a better understanding of the pathogenesis of this process may translate into improved late outcomes.