Drug-eluting stents

Drug-eluting stents are coated with medicine to prevent a coronary artery from narrowing again after angioplasty.

Stents are small, wire-mesh tubes that are inserted during angioplasty into a blocked section of the coronary artery to open the artery and improve blood flow. See a picture of a stent.

Drug-eluting stents were developed to replace standard bare-metal stents, which occasionally caused scar tissue to form and narrow the artery again. Drug-eluting stents are coated with drugs that prevent scar tissue from growing into the artery and thus are more effective in keeping the artery open.

In the SIRIUS and TAXUS trials, drug-eluting stents significantly reduced the risk of reclosure of the affected artery, compared with standard stents.^{1, 2} But experts do not know yet how safe the drug-eluting stents are over the long term or how well they work over the long term.

In the future, drug-eluting stents may even be used to reopen sections of artery that have closed around an old stent. In a small, preliminary trial, drug-eluting stents were found to be safe and effective in keeping the narrowed artery open.³

Whether your doctor chooses to give you a drug-eluting stent will depend in part on your age and any other risk factors (such as diabetes) that make it more likely that your artery will narrow again. In some cases, a second catheterization or coronary artery bypass graft surgery (CABG) may be needed at a later time. Your doctor will also consider your overall health and how well you would be able to handle a second surgery when recommending treatment for you.

Citations

1. Moses JW, et al. (2003). Sirolimus-eluting stents versus standard stents in patients with stenosis in a native coronary artery. New England Journal of Medicine, 349(14): 1315–1323.

2. Stone GW, et al. (2004). A polymer-based, paclitaxel-eluting stent in patients with coronary artery disease. New England Journal of Medicine, 350(3): 221–231.

3. Tanabe K, et al. (2003). TAXUS III trial: In-stent restenosis treated with stent-based delivery of paclitaxel incorporated in a slow-release polymer formulation. Circulation, 107(4): 559–564.