Coated Stents Found to Prevent Restenosis

A study has demonstrated that stents coated with a drug that inhibits cell proliferation can prevent restenosis in patients with coronary artery disease. The findings were presented at the annual meeting of the American College of Cardiology in Atlanta (GA, USA).

The 24-month study involving 30 patients, of whom 29 had repeat angiography at the 24-month follow-up, showed that the coated stents were 100% efficient in preventing restenosis. Two of the patients had disease progression in unstented vessels, while a third patient has a lesion adjacent and proximal to the stent, resulting in a 51% diameter stenosis. Other trials have found similar results. Enrollment has been completed for a large-scale trial involving 1,101 patients and 53 US hospitals.

The stent, called Cypher, was developed by Cordis Corp. (Miami Lakes, FL, USA). The company selected Sirolimus for the coating because of its cytostatic qualities. Known as a cell-cycle inhibitor, sirolimus is a naturally occurring compound that inhibits cell proliferation by targeting replicating smooth muscle cells while simultaneously reducing cytokine production and inflammatory cell activity. Sirolimus exerts its effects early in the cell cycle, rather than late, before DNA replicates and the cell begins to divide. It avoids the problems posed by cytotoxic agents, such as cell necrosis, which could lead to late thrombosis or arterial wall separation.

"Patients have continued to show remarkable results, particularly in regard to sustained lumen cross-sectional area,” said J. Eduardo Sousa, professor of interventional cardiology, Dante Pazzanese Institute (Sao Paulo, Brazil). He noted the 24-month findings of virtually no late lumen loss and 0% in-stent restenosis.




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