This Article Full Text Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by van der Giessen, W. J. Articles by Serruys, P. W. Search for Related Content PubMed PubMed Citation Articles by van der Giessen, W. J. Articles by Serruys, P. W.

(Circulation. 1996;94:2358-2360.)
© 1996 American Heart Association, Inc.

Articles

ß-Particle–Emitting Stents Radiate Enthusiasm in the Search for Effective Prevention of Restenosis

Willem J. van der Giessen, MD, PhD; Patrick W. Serruys, MD, PhD

the Department of Coronary Diagnostics and Intervention, Thoraxcenter, Erasmus University, Rotterdam, the Netherlands.

Correspondence to Wim J. van der Giessen, Department of Coronary Diagnostics and Intervention, Thoraxcenter, Room Bd 412, Erasmus University Rotterdam, 3000 DR Rotterdam, the Netherlands.

Key Words: Editorials • angioplasty • radioisotopes • catheters • stents

	Introduction

 
Renarrowing of a coronary artery (restenosis) at the site of earlier balloon angioplasty is in 1996 still a clinical problem, with an incidence of 30% to 50%. Despite 20 years of experimental and clinical research, the biology of restenosis is still not fully understood. These studies have, however, greatly enhanced our insight into the restenosis process. The most widely accepted concept is that restenosis is the result of the vascular healing response to the injurious treatment. This response includes several phases: elastic recoil, thrombosis, inflammation, proliferation, and organization (or remodeling). Application of therapies aimed at reducing restenosis according to this paradigm has been partially successful. One approach involves the limitation of the thrombotic phase by effectively blocking the platelet glycoprotein IIb/IIIa receptor¹ (preliminary results from the CAPTURE and EPILOG studies support this approach). In these studies, the need for repeated coronary revascularization was substantially reduced but not eliminated. A second approach is the use of coronary stents. By limiting the residual lesion, elastic recoil, and late remodeling, stents reduce the need for both revascularization and angiographic restenosis^{2 3} compared with balloon angioplasty.

Results from more recent nonrandomized studies with stents suggest that an improved deployment technique and/or the use of ticlopidine improve the efficacy of coronary stenting.^{4 5} However, restenosis rates remain written in two-digit numbers. Combination of the antithrombotic approach with coronary stents is currently in clinical trials.

The use of heparin-coated stents was shown to be feasible and safe in the pilot study of the Benestent II trial.⁶ Patient recruitment . . . [Full Text of this Article]

This article has been cited by other articles:

				P. W. Serruys and I. P. Kay I Like the Candy, I Hate the Wrapper : The 32P Radioactive Stent Circulation, January 4, 2000; 101(1): 3 - 7. [Full Text] [PDF]

				A. J. Carter, D. Scott, L. Bailey, T. Hoopes, R. Jones, and R. Virmani Dose-Response Effects of 32P Radioactive Stents in an Atherosclerotic Porcine Coronary Model Circulation, October 5, 1999; 100(14): 1548 - 1554. [Abstract] [Full Text] [PDF]

				D. Meerkin, J.-C. Tardif, I. R. Crocker, A. Arsenault, M. Joyal, G. Lucier, S. B. King III, D. O. Williams, P. W. Serruys, and R. Bonan Effects of Intracoronary ß-Radiation Therapy After Coronary Angioplasty : An Intravascular Ultrasound Study Circulation, April 6, 1999; 99(13): 1660 - 1665. [Abstract] [Full Text] [PDF]

				D. Brieger and E. Topol Local drug delivery systems and prevention of restenosis Cardiovasc Res, September 1, 1997; 35(3): 405 - 413. [Full Text] [PDF]