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Drug Eluting Stent

Drug Eluting Stent

Drug-eluting coronary stents (DES) are placed during a percutaneous transluminal coronary angioplasty (PTCA), a procedure to dilate (widen) narrowed arteries of the heart. A catheter with a deflated balloon at its tip is inserted into a blood vessel in the arm or groin and advanced to the......

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Drug-eluting coronary stents (DES) are placed during a percutaneous transluminal coronary angioplasty (PTCA), a procedure to dilate (widen) narrowed arteries of the heart. A catheter with a deflated balloon at its tip is inserted into a blood vessel in the arm or groin and advanced to the narrowed part of the coronary artery. The balloon is then inflated, pressing against the plaque and/or fatty materials and enlarging the inner diameter of the blood vessel so blood can flow more easily. The balloon is deflated and the catheter removed.

If a stent is to be placed, a stent delivery catheter is then threaded up into the affected area and a stent is left in place. Coronary stents are expandable metal mesh tubes that push against the walls of a coronary artery to keep it open. Due to problems with restenosis following the placement of these stents, drug-eluting stents were designed.

Drug-eluting stents are covered with a drug (e.g., everolimus, sirolimus, zotarolimus, paclitaxel, or ridaforolimus) that is slowly released to help prevent build-up of new tissue that grows in the artery, thereby preventing stenosis. Examples of US Food and Drug Administration (FDA) approved drug-eluting coronary stents may be found on the FDA website.

The use of stents has improved the results of percutaneous coronary re-vascularization. However, in-stent restenosis can occur due to neointimal proliferation of connective tissue. Prior to utilization of coronary stents, restenosis ranged between 32 to 55 % of all angioplasties. With the placement of bare metal stents (BMS), the rate of restenosis dropped to 17 to 41 %. The advent of DES, especially 2nd generation, and drug-coated balloon further reduced restenosis rates to less than 10 % (Buccheri et al, 2016).