Content uploaded by Sanjay Chugh Author content All content in this area was uploaded by Sanjay Chugh on Jul 06, Content may be subject to copyright. Indian Heart J ; β Original Article Percutaneous invasion of coronary arteries began with Andreas Gruentzig, who performed the first human percuta- neous transluminal coronary angioplasty PTCA.
Stents, which overcame many of the limitations encountered with PTCA alone, were the next big milestone in the field of inter- ventional cardiology. Restenosis is the result of neo-intimal prolif- eration which occurs after the deployment of a stent. The various drugs used to coat the stent are capable of suppress- ing neo-intimal proliferation.
Sirolimus, a macrolide antibi- otic with immunosuppressive and cytostatic properties, is one such drug. It interacts with the mammalian target of rapamycin m-TOR receptor, causing down-regulation of cyclic dependant kinase, thereby arresting cell growth.
A polymer is utilized as a vehicle to coat the surface of the stent with this drug. The polymer also controls the extended release pharmacokinetics of a drug inside the human arteries. The ProPass stent CE-marked has been implanted in a large number of patients with good acute and long-term results. The introduction of drug-eluting stents has decreased the rate of restenosis. Various drug-eluting stents, using different drugs and stent designs, are now being used in interventional cardiology worldwide.
The EMPIRE study was conducted to evaluate the safety and efficacy of the slow-release sirolimus-eluting ProNova stent in coronary artery lesions in patients with single- or multi-vessel disease. They were followed up clinically, first at 30 days and then six months after the procedure for parameters like death, target vessel failure, documented myocardial infarction and restenosis.
