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01.05.2011 | Schwerpunkt/CME

Neue Entwicklungen bei medikamentenfreisetzenden Stents

verfasst von: PD Dr. M. Kollum, C. Bode

Erschienen in: Herz | Ausgabe 3/2011

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Zusammenfassung

Auch wenn der Einsatz eines Ballonkatheters sowie eines Edelstahl-Stent zur Behandlung koronarer Läsionen einen guten Kurzzeiterfolg zeigt, ist die Langzeitprognose aufgrund des Auftretens einer Restenose bei 20–30% der Patienten weniger erfolgversprechend. Diese Tatsache führt dazu, dass immer neue Techniken und mechanische Verbesserungen an Ballons und Stents notwendig sind, um ein möglichst gutes Ergebnis nach perkutaner Koronarintervention zu erreichen. Medikamentenfreisetzende Stents (DES) verbessern die Prinzipien des Edelstahl-Stent, indem sie ein neointimales Wachstum durch die lokale Freisetzung eines Medikaments verhindern. DES können die Inzidenz der In-Stent-Restenose deutlich reduzieren. Diese Vorteile und die niedrigeren Kosten machen den DES gegenüber der chirurgischen Intervention zur attraktiveren Alternative für die Behandlung der koronaren Herzerkrankung. Derzeit sind der CYPHER-Sirolimus-freisetzender-Stent (SES) von Cordis (zugelassen durch die FDA am 24. April 2003), der TAXUS-Express- und Liberté-Paclitaxel-freisetzender-Stent (PES) von Boston Scientific (zugelassen durch die FDA am 4. März 2004 und 10 Oktober 2008), der ENDEAVOR-Zotarolimus-freisetzender-Stent (ZES) von Medtronic (zugelassen durch die FDA am 1. Februar 2008) und der XIENCE-V-Everolimus-freisetzender-Stent (EES) von Abbott Vascular (zugelassen durch die FDA am 2. Juli 2008) in den USA verfügbar. Nach der Zulassung des Cypher- und Taxus-Stent zeigen die klinischen Daten eine leicht erhöhte Inzidenz an Stent-Thrombosen (ST) bei den DES im Vergleich zu den reinen Edelstahl-Stents. Im Rahmen dieses Reviews sollen die wichtigsten klinischen Studien sowie das Design und die Schlüsseleigenschaften der momentan verfügbaren DES diskutiert sowie ein Blick auf die zukünftigen Technologien bei DES gerichtet werden.

Barragan P, Rieu R, Garitey V et al (2000) Elastic recoil of coronary stents: a comparative analysis. Catheter Cardiovasc Interv 50(1):112–119PubMedCrossRef

Ormiston JA, Dixon SR, Webster MW et al (2000) Stent longitudinal flexibility: a comparison of 13 stent designs before and after balloon expansion. Catheter Cardiovasc Interv 50(1):120–124PubMedCrossRef

Ku DN, Giddens DP, Zarins CK et al (1985) Pulsatile flow and atherosclerosis in the human carotid bifurcation. Positive correlation between plaque location and low oscillating shear stress. Arteriosclerosis 5(3):293–302PubMed

Malek AM, Alper SL, Izumo S (1999) Hemodynamic shear stress and its role in atherosclerosis. JAMA 282(21):2035–2042PubMedCrossRef

Kastrati A, Dirschinger J, Boekstegers P et al (2000) Influence of stent design on 1-year outcome after coronary stent placement: a randomized comparison of five stent types in 1,147 unselected patients. Catheter Cardiovasc Interv 50(3):290–297PubMedCrossRef

Hoffmann R, Jansen C, Konig A et al (2001) Stent design related neointimal tissue proliferation in human coronary arteries; an intravascular ultrasound study. Eur Heart J 22(21):2007–2014PubMedCrossRef

Kastrati A, Mehilli J, Dirschinger J et al (2001) Restenosis after coronary placement of various stent types. Am J Cardiol 87(1):34–39PubMedCrossRef

Rogers C, Edelman ER (1995) Endovascular stent design dictates experimental restenosis and thrombosis. Circulation 91(12):2995–3001PubMed

Yoshitomi Y, Kojima S, Yano M et al (2001) Does stent design affect probability of restenosis? A randomized trial comparing Multilink stents with GFX stents. Am Heart J 142(3):445–451PubMedCrossRef

10.

Hoeven BL van der, Pires NM, Warda HM et al (2005) Drug-eluting stents: results, promises and problems. Int J Cardiol 99(1):9–17PubMedCrossRef

11.

Ong AT, Serruys PW (2005) Technology Insight: an overview of research in drug-eluting stents. Nat Clin Pract Cardiovasc Med (12):647–658CrossRef

12.

Regar E, Sianos G, Serruys PW (2001) Stent development and local drug delivery. Br Med Bull 59:227–248PubMedCrossRef

13.

Winslow RD, Sharma SK, Kim MC (2005) Restenosis and drug-eluting stents. Mt Sinai J Med 72(2):81–89PubMed

14.

Tanabe K, Regar E, Lee CH et al (2004) Local drug delivery using coated stents: new developments and future perspectives. Curr Pharm Des 10(4):357–367PubMedCrossRef

15.

Wong A, Chan C (2004) Drug-eluting stents: the end of restenosis? Ann Acad Med Singapore 33(4):423–431PubMed

16.

Morice MC, Serruys PW, Sousa JE et al (2002) A randomized comparison of a sirolimus-eluting stent with a standard stent for coronary revascularization. N Engl J Med 346(23):1773–1780PubMedCrossRef

17.

Schampaert E, Cohen EA, Schluter M et al (2004) The Canadian study of the sirolimus-eluting stent in the treatment of patients with long de novo lesions in small native coronary arteries (C-SIRIUS). J Am Coll Cardiol 43(6):1110–1115PubMedCrossRef

18.

Moses JW, Leon MB, Popma JJ et al (2003) Sirolimus-eluting stents versus standard stents in patients with stenosis in a native coronary artery. N Engl J Med 349(14):1315–1323PubMedCrossRef

19.

Weisz G, Leon MB, Holmes DR Jr et al (2006) Two-year outcomes after sirolimus-eluting stent implantation: results from the Sirolimus-Eluting Stent in de Novo Native Coronary Lesions (SIRIUS) trial. J Am Coll Cardiol 47(7):1350–1355PubMedCrossRef

20.

Grube E, Silber S, Hauptmann KE et al (2003) TAXUS I: six- and twelve-month results from a randomized, double-blind trial on a slow-release paclitaxel-eluting stent for de novo coronary lesions. Circulation 107(1):38–42PubMedCrossRef

21.

Colombo A, Drzewiecki J, Banning A et al (2003) Randomized study to assess the effectiveness of slow- and moderate-release polymer-based paclitaxel-eluting stents for coronary artery lesions. Circulation 108(7):788–794PubMedCrossRef

22.

Stone GW, Ellis SG, Cox DA et al (2004) A polymer-based, paclitaxel-eluting stent in patients with coronary artery disease. N Engl J Med 350(3):221–231PubMedCrossRef

23.

Ellis SG, Popma JJ, Lasala JM et al (2005) Relationship between angiographic late loss and target lesion revascularization after coronary stent implantation: analysis from the TAXUS-IV trial. J Am Coll Cardiol 45(8):1193–1200PubMedCrossRef

24.

Stone GW, Ellis SG, Cannon L et al (2005) Comparison of a polymer-based paclitaxel-eluting stent with a bare metal stent in patients with complex coronary artery disease: a randomized controlled trial. JAMA 294(10):1215–1223PubMedCrossRef

25.

Turco MA, Ormiston JA, Popma JJ et al (2007) Polymer-based, paclitaxel-eluting TAXUS Liberte stent in de novo lesions: the pivotal TAXUS ATLAS trial. J Am Coll Cardiol 49(16):1676–1683PubMedCrossRef

26.

Fajadet J, Wijns W, Laarman GJ et al (2006) Randomized, double-blind, multicenter study of the Endeavor zotarolimus-eluting phosphorylcholine-encapsulated stent for treatment of native coronary artery lesions: clinical and angiographic results of the ENDEAVOR II trial. Circulation 114(8):798–806PubMedCrossRef

27.

Eisenstein EL, Leon MB, Kandzari DE et al (2009) Long-term clinical and economic analysis of the Endeavor zotarolimus-eluting stent versus the cypher sirolimus-eluting stent: 3-year results from the ENDEAVOR III trial (Randomized Controlled Trial of the Medtronic Endeavor Drug [ABT-578] Eluting Coronary Stent System Versus the Cypher Sirolimus-Eluting Coronary Stent System in De Novo Native Coronary Artery Lesions). JACC Cardiovasc Interv 2(12):1199–1207PubMedCrossRef

28.

Waseda K, Miyazawa A, Ako J et al (2009) Intravascular ultrasound results from the ENDEAVOR IV trial: randomized comparison between zotarolimus- and paclitaxel-eluting stents in patients with coronary artery disease. JACC Cardiovasc Interv 2(8):779–784PubMedCrossRef

29.

Meredith IT, Worthley S, Whitbourn R et al (2007) The next-generation Endeavor Resolute stent: 4-month clinical and angiographic results from the Endeavor Resolute first-in-man trial. EuroIntervention 3(1):50–53PubMed

30.

Udipi K, Melder RJ, Chen M et al (2007) The next generation Endeavor Resolute Stent: role of the BioLinx Polymer System. EuroIntervention 3(1):137–139PubMed

31.

Meredith IT, Worthley S, Whitbourn R et al (2009) Clinical and angiographic results with the next-generation resolute stent system: a prospective, multicenter, first-in-human trial. JACC Cardiovasc Interv 2(10):977–985PubMedCrossRef

32.

Meredith IT, Worthley SG, Whitbourn R et al (2010) Long-term clinical outcomes with the next-generation Resolute Stent System: a report of the two-year follow-up from the RESOLUTE clinical trial. EuroIntervention 5(6):692–697PubMedCrossRef

33.

Serruys PW, Silber S, Garg S et al (2010) Comparison of zotarolimus-eluting and everolimus-eluting coronary stents. N Engl J Med 363(2):136–146PubMedCrossRef

34.

Tsuchida K, Piek JJ, Neumann FJ et al (2005) One-year results of a durable polymer everolimus-eluting stent in de novo coronary narrowings (The SPIRIT FIRST Trial). EuroIntervention 1(3):266–272PubMed

35.

Serruys PW, Ruygrok P, Neuzner J et al (2006) A randomised comparison of an everolimus-eluting coronary stent with a paclitaxel-eluting coronary stent: the SPIRIT II trial. EuroIntervention 2(3):286–294PubMed

36.

Beijk MA, Neumann FJ, Wiemer M et al (2007) Two-year results of a durable polymer everolimus-eluting stent in de novo coronary artery stenosis (The SPIRIT FIRST Trial). EuroIntervention 3(2):206–212PubMedCrossRef

37.

Claessen BE, Beijk MA, Legrand V et al (2009) Two-year clinical, angiographic, and intravascular ultrasound follow-up of the XIENCE V everolimus-eluting stent in the treatment of patients with de novo native coronary artery lesions: the SPIRIT II trial. Circ Cardiovasc Interv 2(4):339–347PubMedCrossRef

38.

Stone GW, Midei M, Newman W et al (2009) Randomized comparison of everolimus-eluting and paclitaxel-eluting stents: two-year clinical follow-up from the clinical evaluation of the Xience V Everolimus Eluting Coronary Stent System in the Treatment of Patients with de novo Native Coronary Artery Lesions (SPIRIT) III trial. Circulation 119(5):680–686PubMedCrossRef

39.

Onuma Y, Serruys PW, Kukreja N et al (2010) Randomized comparison of everolimus- and paclitaxel-eluting stents: pooled analysis of the 2-year clinical follow-up from the SPIRIT II and III trials. Eur Heart J 31(9):1071–1078PubMedCrossRef

40.

Kedhi E, Stone GW (2010) Everolimus-eluting stents: insights from the SPIRIT IV and COMPARE trials. Expert Rev Cardiovasc Ther 8(9):1207–1210PubMedCrossRef

41.

Nikolsky E, Lansky AJ, Sudhir K et al (2009) SPIRIT IV trial design: a large-scale randomized comparison of everolimus-eluting stents and paclitaxel-eluting stents in patients with coronary artery disease. Am Heart J 158(4):520–526PubMedCrossRef

42.

Kedhi E, Joesoef KS, McFadden E et al (2010) Second-generation everolimus-eluting and paclitaxel-eluting stents in real-life practice (COMPARE): a randomised trial. Lancet 375(9710):201–209PubMedCrossRef

43.

Costa JR Jr, Abizaid A, Feres F et al (2008) EXCELLA First-in-Man (FIM) study: safety and efficacy of novolimus-eluting stent in de novo coronary lesions. EuroIntervention 4(1):53–58PubMedCrossRef

44.

Serruys PW, Garg S, Abizaid A et al (2010) A randomised comparison of novolimus-eluting and zotarolimus-eluting coronary stents: 9-month follow-up results of the EXCELLA II study. EuroIntervention 6(2):195–205PubMedCrossRef

45.

Kastrati A, Mehilli J, Dirschinger J et al (2001) Intracoronary stenting and angiographic results: strut thickness effect on restenosis outcome (ISAR-STEREO) trial. Circulation 103(23):2816–2821PubMed

46.

Pache J, Kastrati A, Mehilli J et al (2003) Intracoronary stenting and angiographic results: strut thickness effect on restenosis outcome (ISAR-STEREO-2) trial. J Am Coll Cardiol 41(8):1283–1288PubMedCrossRef

47.

Kereiakes DJ, Cannon LA, Feldman RL et al (2010) Clinical and angiographic outcomes after treatment of de novo coronary stenoses with a novel platinum chromium thin-strut stent: primary results of the PERSEUS (Prospective Evaluation in a Randomized Trial of the Safety and Efficacy of the Use of the TAXUS Element Paclitaxel-Eluting Coronary Stent System) trial. J Am Coll Cardiol 56(4):264–271PubMedCrossRef

48.

De Jong WH, Eelco BJ, Robinson JE et al (2005) Tissue response to partially in vitro predegraded poly-L-lactide implants. Biomaterials 26(14):1781–1791CrossRef

49.

Dani S, Kukreja N, Parikh P et al (2008) Biodegradable-polymer-based, Sirolimus-eluting Supralimus stent: 6-month angiographic and 30-month clinical follow-up results from the series I prospective study. EuroIntervention 4(1):59–63PubMedCrossRef

50.

Han Y, Jing Q, Xu B et al (2009) Safety and efficacy of biodegradable polymer-coated sirolimus-eluting stents in „real-world“ practice: 18-month clinical and 9-month angiographic outcomes. JACC Cardiovasc Interv 2(4):303–309PubMedCrossRef

51.

Serruys PW, Sianos G, Abizaid A et al (2005) The effect of variable dose and release kinetics on neointimal hyperplasia using a novel paclitaxel-eluting stent platform: the Paclitaxel In-Stent Controlled Elution Study (PISCES). J Am Coll Cardiol 46(2):253–260PubMedCrossRef

52.

Kaul U, Gupta RK, Mathur A et al (2007) Cobalt chromium stent with antiproliferative for restenosis trial in India (COSTAR I). Indian Heart J 59(2):165–172PubMed

53.

Krucoff MW, Kereiakes DJ, Petersen JL et al (2008) A novel bioresorbable polymer paclitaxel-eluting stent for the treatment of single and multivessel coronary disease: primary results of the COSTAR (Cobalt Chromium Stent With Antiproliferative for Restenosis) II study. J Am Coll Cardiol 51(16):1543–1552PubMedCrossRef

54.

Ormiston JA, Abizaid A, Spertus J et al (2010) Six-month results of the NEVO Res-Elution I (NEVO RES-I) trial: a randomized, multicenter comparison of the NEVO sirolimus-eluting coronary stent with the TAXUS Liberte paclitaxel-eluting stent in de novo native coronary artery lesions. Circ Cardiovasc Interv 3(6):556–564PubMedCrossRef

55.

Garg S, Sarno G, Serruys PW et al (2010) The twelve-month outcomes of a biolimus eluting stent with a biodegradable polymer compared with a sirolimus eluting stent with a durable polymer. EuroIntervention 6(2):233–239PubMedCrossRef

56.

Ostojic M, Sagic D, Beleslin B et al (2008) First clinical comparison of Nobori -Biolimus A9 eluting stents with Cypher- Sirolimus eluting stents: Nobori Core nine months angiographic and one year clinical outcomes. EuroIntervention 3(5):574–579PubMedCrossRef

57.

Chevalier B, Silber S, Park SJ et al (2009) Randomized comparison of the Nobori Biolimus A9-eluting coronary stent with the Taxus Liberte paclitaxel-eluting coronary stent in patients with stenosis in native coronary arteries: the NOBORI 1 trial – Phase 2. Circ Cardiovasc Interv 2(3):188–195PubMedCrossRef

58.

Grube E, Schofer J, Hauptmann KE et al (2010) A novel paclitaxel-eluting stent with an ultrathin abluminal biodegradable polymer 9-month outcomes with the JACTAX HD stent. JACC Cardiovasc Interv 3(4):431–438PubMedCrossRef

59.

Wessely R, Hausleiter J, Michaelis C et al (2005) Inhibition of neointima formation by a novel drug-eluting stent system that allows for dose-adjustable, multiple, and on-site stent coating. Arterioscler Thromb Vasc Biol 25(4):748–753PubMedCrossRef

60.

Mehilli J, Kastrati A, Wessely R et al (2006) Randomized trial of a nonpolymer-based rapamycin-eluting stent versus a polymer-based paclitaxel-eluting stent for the reduction of late lumen loss. Circulation 113(2):273–279PubMedCrossRef

61.

Ruef J, Storger H, Schwarz F et al (2008) Comparison of a polymer-free rapamycin-eluting stent (YUKON) with a polymer-based paclitaxel-eluting stent (TAXUS) in real-world coronary artery lesions. Catheter Cardiovasc Interv 71(3):333–339PubMedCrossRef

62.

Byrne RA, Iijima R, Mehilli J et al (2009) Durability of antirestenotic efficacy in drug-eluting stents with and without permanent polymer. JACC Cardiovasc Interv 2(4):291–299PubMedCrossRef

63.

Tada N, Virmani R, Grant G et al (2010) Polymer-free biolimus a9-coated stent demonstrates more sustained intimal inhibition, improved healing, and reduced inflammation compared with a polymer-coated sirolimus-eluting cypher stent in a porcine model. Circ Cardiovasc Interv 3(2):174–173PubMedCrossRef

64.

Giessen WJ van der, Sorop O, Serruys PW et al (2009) Lowering the dose of sirolimus, released from a nonpolymeric hydroxyapatite coated coronary stent, reduces signs of delayed healing. JACC Cardiovasc Interv 2(4):284–290PubMedCrossRef

65.

Costa JR Jr, Abizaid A, Costa R et al (2009) 1-year results of the hydroxyapatite polymer-free sirolimus-eluting stent for the treatment of single de novo coronary lesions: the VESTASYNC I trial. JACC Cardiovasc Interv 2(5):422–427PubMedCrossRef

66.

Spuentrup E, Ruebben A, Mahnken A et al (2005) Artifact-free coronary magnetic resonance angiography and coronary vessel wall imaging in the presence of a new, metallic, coronary magnetic resonance imaging stent. Circulation 111(8):1019–1026PubMedCrossRef

67.

Tanimoto S, Serruys PW, Thuesen L et al (2007) Comparison of in vivo acute stent recoil between the bioabsorbable everolimus-eluting coronary stent and the everolimus-eluting cobalt chromium coronary stent: insights from the ABSORB and SPIRIT trials. Catheter Cardiovasc Interv 70(4):515–523PubMedCrossRef

68.

Ormiston JA, Serruys PW, Regar E et al (2008) A bioabsorbable everolimus-eluting coronary stent system for patients with single de-novo coronary artery lesions (ABSORB): a prospective open-label trial. Lancet 371(9616):899–907PubMedCrossRef

69.

Serruys PW, Ormiston JA, Onuma Y et al (2009) A bioabsorbable everolimus-eluting coronary stent system (ABSORB): 2-year outcomes and results from multiple imaging methods. Lancet 373(9667):897–910PubMedCrossRef

70.

Ormiston JA, Webster MW, Armstrong G (2007) First-in-human implantation of a fully bioabsorbable drug-eluting stent: the BVS poly-L-lactic acid everolimus-eluting coronary stent. Catheter Cardiovasc Interv 69(1):128–131PubMedCrossRef

71.

Serruys PW, Ong AT, Piek JJ et al (2005) A randomized comparison of a durable polymer Everolimus-eluting stent with a bare metal coronary stent: the SPIRIT first trial. EuroIntervention 1(1):58–65PubMed

72.

Erbel R, Di MC, Bartunek J et al (2007) Temporary scaffolding of coronary arteries with bioabsorbable magnesium stents: a prospective, non-randomised multicentre trial. Lancet 369(9576):1869–1875PubMedCrossRef

73.

Waksman R, Pakala R, Kuchulakanti PK et al (2006) Safety and efficacy of bioabsorbable magnesium alloy stents in porcine coronary arteries. Catheter Cardiovasc Interv 68(4):607–617PubMedCrossRef

74.

Gershlick A, Kandzari DE, Leon MB et al (2007) Zotarolimus-eluting stents in patients with native coronary artery disease: clinical and angiographic outcomes in 1,317 patients. Am J Cardiol 100(8B):45M–55MPubMedCrossRef

75.

Leon MB, Mauri L, Popma JJ et al (2010) A randomized comparison of the ENDEAVOR zotarolimus-eluting stent versus the TAXUS paclitaxel-eluting stent in de novo native coronary lesions 12-month outcomes from the ENDEAVOR IV trial. J Am Coll Cardiol 55(6):543–554PubMedCrossRef

76.

Regar E, Serruys PW, Bode C et al (2002) Angiographic findings of the multicenter Randomized Study With the Sirolimus-Eluting Bx Velocity Balloon-Expandable Stent (RAVEL): sirolimus-eluting stents inhibit restenosis irrespective of the vessel size. Circulation 106(15):1949–1956PubMedCrossRef

77.

Moses JW, Weisz G, Mishkel G et al (2007) The SIRIUS-DIRECT trial: a multi-center study of direct stenting using the sirolimus-eluting stent in patients with de novo native coronary artery lesions. Catheter Cardiovasc Interv 70(4):505–512PubMedCrossRef

78.

Schofer J, Schluter M, Gershlick AH et al (2003) Sirolimus-eluting stents for treatment of patients with long atherosclerotic lesions in small coronary arteries: double-blind, randomised controlled trial (E-SIRIUS). Lancet 362(9390):1093–1099PubMedCrossRef

79.

Tanabe K, Serruys PW, Degertekin M et al (2004) Chronic arterial responses to polymer-controlled paclitaxel-eluting stents: comparison with bare metal stents by serial intravascular ultrasound analyses: data from the randomized TAXUS-II trial. Circulation 109(2):196–200PubMedCrossRef

80.

Stone GW, Ellis SG, Cox DA et al (2004) One-year clinical results with the slow-release, polymer-based, paclitaxel-eluting TAXUS stent: the TAXUS-IV trial. Circulation 109(16):1942–1947PubMedCrossRef

81.

Dawkins KD, Grube E, Guagliumi G et al (2005) Clinical efficacy of polymer-based paclitaxel-eluting stents in the treatment of complex, long coronary artery lesions from a multicenter, randomized trial: support for the use of drug-eluting stents in contemporary clinical practice. Circulation 112(21):3306–3313PubMedCrossRef

Titel: Neue Entwicklungen bei medikamentenfreisetzenden Stents
verfasst von: PD Dr. M. Kollum
C. Bode
Publikationsdatum: 01.05.2011
Verlag: Urban and Vogel
Erschienen in: Herz / Ausgabe 3/2011
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI: https://doi.org/10.1007/s00059-011-3457-0

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