MUKUND LATA BHARTI
ABSTRACT
Cardiovascular diseases are one of the major causes of death in industrially developed countries. In particular occlusive pathologies of coronary and peripheral arteries are the third cause of death in these countries. The recent introduction of drug eluting stents (DES) technology contributes a major advancement in the treatment of obstructive coronary – artery diseases. A DES is a peripheral or coronary stent ( scaffold ) which slowly elutes a drug locally, design to limit the growth of neointimal scar tissue; thus reducing the likelihood of stent restenosis. In DES designing the Stent platform (metallic platform), Coating (a drug carrier vehicle which holds and elutes the drug in a controlled manner), Active therapeutic agent (reduces neointimal growth) are three major parts are used; for stent platform different type of metallic can be used like stainless steel, nitinol, cobalt, chromium, platinum, gold, magnesium alloy etc, and polymers which are generally used in DES are may be Biodegradable polymers (like poly lacticacid (PLA), poly glycolic acid (PLGA), poly caprolactone (PCL) etc. or Non biodegradable polymers (like polybutylmethacrylate (PBMA), polymethyl-methacrylate (PMMA), phosphorylcholine, polyethyleneterphthalate (PET) and the drug incorporated in the stent is basically Immunosuppressive and Antiproliferative drugs like Sirolimus, Everolimus, Zotarolimus, Paclitaxel etc. to inhibit neointimal growth which would cause restenosis. The success of DES in a long term clinical outcome basically depends upon Stent configuration, Strut Thickness, Stent coating, and Drug elution. Therefore, the introduction of DES in percutaneous coronary intervention (PCI) is a major innovative advancement in interventional cardiology. DES dramatically reduces the ISR rate in all subgroups of patients. Continuing improvement in drug delivery stent technologies and gradual reduction in cost makes DES an effective mainstay of therapy for CAD.
Key Words: Stent, Coating, Restenosis, Drug loading, Coronary artery disease (CAD).