Percutaneous Coronary Intervention (PCI) in the Era of Drug-Eluting Stents

Abstract

Angioplasty opened the stenotic coronary artery but faced complication like abrupt vessel closure. Deployment of bare metal stent within the lesion solved the problem but another complication like restenosis emerged. Neointimal hyperplasia and vessel wall remodeling were identified as the underlying mechanism and lead to the development of drug eluting stent. In the selected patient group, drug eluting stent (sirolimus and paclitaxel) are proved to be extremely promising in respect to reduction of target vessel failure, clinical restenosis (target vessel revascularization), binary restenosis, stent thrombosis and other parameters. Importantly initial positive outcome persisted in the subsequent later follow ups. Outcome in the unfavourable groups are also encouraging but needs few more studies and follow ups. There are scopes for future improvement also. With the immense success, drug eluting stents are increasingly used worldwide and becoming an integral part of percutaneous coronary intervention. (J Bangladesh Coll Phys Surg 2007; 25 : 86-91)