الفهرس | Only 14 pages are availabe for public view |
Abstract Coronary artery disease is the leading cause of morbidity and mortality in the world, with a vast majority of these deaths attributed to obstructive coronary artery disease. Depending on the severity of the coronary artery disease, the main interventional options for revascularization include percutaneous coronary intervention and bypass graft surgery. Percutaneous coronary intervention procedures include percutaneous transluminal coronary balloon angioplasty and coronary vascular stents such as bare metal stents and drug eluting stents. The goal of interventional cardiology has been maximizing the safety and efficacy of coronary revascularization. Percutaneous transluminal coronary balloon angioplasty was a successful anti-anginal therapy in the short term, but acute adverse events and a high rate of restenosis reduced its long term effectiveness. While the introduction of bare metal stents improved upon the safety of angioplasty, long term results were limited by neointimal hyperplasia leading to in stent restenosis. Drug eluting stents dramatically reduced the in stent restenosis seen with bare metal stents, but their long term inhibition of neointimal growth slightly increased the risk of late stent thrombosis. Second generation stents, with multiple improvements over the earlier drug eluting stents, appear to preserve the anti restenotic benefits, while mitigating the long term risk of stent thrombosis. |