Frontiers in Interventional Cardiology

Abstract

I n more than 20 years since the first percutaneous coronary revascularization procedures, the field of interventional cardiology has proliferated beyond all expectations. Now more than 1 million procedures are performed worldwide each year. Stenting has revolutionized the field, which previously relied on balloon dilatation in the majority of patients. With Ϸ50% of patients now undergoing stent implantation, the groundwork is laid for further important advances. In this article, we discuss the 4 most important new advances in the field of interventional cardiology: platelet inhibition, prevention of restenosis, stent evolution, and angiogenesis.

c-Jun Regulates Shear- and Injury-inducible Egr-1 Expression, Vein Graft Stenosis after Autologous End-to-Side Transplantation in Rabbits, and Intimal Hyperplasia in Human Saphenous Veins

“…Fitzgibbon et al (3) found that patency rates of saphenous vein grafts in patients undergoing CABG 1, 5, and 10 years after surgery were 78%, 65, and 57%, respectively. Although statins improve graft patency by ϳ24 -29% (4), poor long term patency, and the lack of other pharmacologic agents preventing graft failure, necessitates the search for effective alternative therapies and surgical techniques (5). The cellular processes underlying intimal hyperplasia and vein graft failure are smooth muscle cell (SMC) proliferation and migration.…”

The cell cycle: A critical therapeutic target to prevent vascular proliferative disease

“…Coronary stenting prevents acute elastic recoil and negative remodelling, but does not have any effect against neointimal formation (5). In fact, stenting appears to actually increase cell proliferative components of intimal hyperplasia in restenosis (6)(7)(8)(9). Although multiple cell types, cytokines and mediators all play roles in the complex process of neointimal formation, there is a final common pathway: the entry of VSMCs into the cell cycle.…”

Non–Polymer-Based Paclitaxel-Coated Coronary Stents for the Treatment of Patients With De Novo Coronary Lesions

“…[17][18] Recent clinical trials of polymerand non-polymer-based paclitaxel-and sirolimus-eluting stents have demonstrated promising results in the treatment of de novo coronary lesions. 19 -24 Because early studies investigating the biocompatibility of synthetic polymers showed significant inflammatory and proliferative responses, [25][26] the use of nonpolymer-based local drug delivery became an attractive approach.…”