Prevention of restenosis by a novel drug-eluting stent system with a dose-adjustable, polymer-free, on-site stent coating

  • Aims Drug-eluting stents (DES) represent a major advance in interventional cardiology. Along with the success shown, current DES also present limitations related to the presence of polymer-coating, fixed drug, and dose used. With the ISAR (Individualized Drug-Eluting Stent System to Abrogate Restenosis) project, a DES system has been developed that permits individualized choice of the drug and dose to use for the given patient. The objective of this prospective dose finding study was to assess the feasibility, safety, and efficacy of a polymer-free on-site stent coating with increasing rapamycin doses. Methods and results In this dose finding study, 602 patients were sequentially enrolled in four groups: microporous bare metal stent (BMS), DES stents coated with a 0.5, 1.0, and 2.0% rapamycin solution. The angiographic in-segment restenosis rate at follow-up angiography was the primary study endpoint. In-segment restenosis was significantly reduced from 25.9% with BMS to 18.9, 17.2, and 14.7% with 0.5, 1.0, and 2.0% rapamycin-eluting stents, respectively (P=0.024). Similarly, the need for target lesion revascularization at 1 year follow-up was reduced from 21.5% with BMS to 16.4, 12.6, and 8.8% with 0.5, 1.0, and 2.0% rapamycin-eluting stents, respectively (P=0.006). Conclusion The placement of polymer-free stents coated on-site with rapamycin is feasible and safe. Furthermore, a dose-dependent efficacy in restenosis prevention is achievable with this new DES concept.

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Author:Jörg Hausleiter, Adnan Kastrati, Rainer Wessely, Alban Dibra, Julinda Mehilli, Thomas SchratzenstallerORCiD, Isolde Graf, Magdalena Renke-Gluszko, Boris Behnisch, Josef Dirschinger, Erich Wintermantel, Albert Schömig
Parent Title (English):European Heart Journal - Clinical research
Document Type:Article
Year of first Publication:2005
Release Date:2021/11/22
Tag:Polymer; Randomized; Rapamycin; Restenosis; Stents
First Page:1475
Last Page:1481
Institutes:Fakultät Maschinenbau
Regensburg Center of Biomedical Engineering - RCBE
Fakultät Maschinenbau / Labor Medizinprodukte
Publication:Externe Publikationen
research focus:Lebenswissenschaften und Ethik