Radioactive stents: problems and potential solutions

The implantation of radioactive stents was the first procedure of a coronary brachytherapy in Europe examined in multicenter clinical trials. After more than 400 patients with radioactive stents were analyzed, it became clear that overall restenosis rates were not reduced. A new phenomenon called th...

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Bibliographic Details
Published in:Herz 2002-02, Vol.27 (1), p.17-22
Main Author: Hehrlein, Christoph
Format: Article
Language:ger
Subjects:
Angioplasty, Balloon, Coronary
Antibiotics, Antineoplastic - administration & dosage
Brachytherapy
Coronary Angiography
Coronary Restenosis - prevention & control
Humans
Immunosuppressive Agents - administration & dosage
Phosphorus Radioisotopes - administration & dosage
Pilot Projects
Randomized Controlled Trials as Topic
Sirolimus - administration & dosage
Stainless Steel
Stents
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Summary:The implantation of radioactive stents was the first procedure of a coronary brachytherapy in Europe examined in multicenter clinical trials. After more than 400 patients with radioactive stents were analyzed, it became clear that overall restenosis rates were not reduced. A new phenomenon called the "edge effect" or "candy-wrapper" effect was discovered, which later was also described for catheter-based brachytherapy. Currently, the implantation of radioactive stents for the prevention of restenosis cannot be recommended. Although technical improvements of radioactive stents are theoretically possible, novel drug coated stents may overcome any future research of stent-based radiotherapy. Drug eluting stents induce antiproliferative effects beyond the stent margins. Edge effects were not observed in preliminary trials. However, long-term results need to be awaited.
ISSN:0340-9937
DOI:10.1007/s15010-002-2338-0