Drug-Eluting Stents

The use of Drug-Eluting Stents (DES) in the interventional practise has proved to largely reduce restenosis. Recent publications and communications have highlighted that within this positive, medium and long-term scenario, there is an unfavourable aspect with consequences still to be discussed. Thus, the prevention of vascular scarring could imply an increase of non-beneficial effects, such as sub-acute and late thrombosis. After a series of related presentations in Barcelona, the results shown in Washington recommended waiting for the analysis of new emerging data, so as to draw more appropriate conclusions in this regard.

An increased risk of long-term stent thrombosis in DES stems from trials carried out to evaluate more complex aspects, such as survival and restenosis. Nevertheless, it is not possible to elude this incipient evidence and therefore it is expected that a series of trials such as Stent Thrombosis, INSIGHT and PROTECT will shed light on this subject.
There is no doubt that this question will have to be answered immediately and that the bare-metal stents safety equivalence will have to be weighed up in order to keep pondering the highest effectiveness of DES. On the other hand, the extremely high degree of technological development will introduce new devices to the market; in this regard, biodegradable stents promise to add new significance to the endothelization.

The upcoming scientific events will clarify the exact role of the use of drugs in the post-angioplasty treatment. In most of the trials carried out so far, antiplatelet agents were used just for a few months, when the current available evidence recommends its use for longer periods.

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