How do drug-eluting stents inhibit restenosis?
The predominant, almost exclusive, mechanism of lumen renarrowing after placement of coronary stents is neointimal formation due to smooth muscle cell proliferation. Putting drugs on stents (drug-eluting stents) that inhibit smooth muscle cell proliferation is shown to be effective for the prevention of restenosis. Q: Which stents are better at decreasing restenosis? A: Two drug-eluting stents (Cypher, a sirolimus-eluting stent, and Taxus, a paclitaxel-eluting stent) have been more thoroughly studied in various risk subsets of lesions and patients. Both have been associated with a remarkable reduction of restenosis risk compared with their bare-metal stent counterpart. Meanwhile, there have been at least 10 randomised trials enrolling more than 5,000 patients that have compared Cypher stents directly with Taxus stents in different patient populations. In fact, the randomised clinical trial is the only acceptable tool of comparing different devices or drugs. These trials have clearly sh
