Chonnam Med J.  2017 Jan;53(1):14-27. 10.4068/cmj.2017.53.1.14.

Drug- and Gene-eluting Stents for Preventing Coronary Restenosis

• Lekshmi KM
• Che HL
• Cho CS
• Park IK

• KMID: 2367336
• DOI: http://doi.org/10.4068/cmj.2017.53.1.14

Abstract

Coronary artery disease (CAD) has been reported to be a major cause of death worldwide. Current treatment methods include atherectomy, coronary angioplasty (as a percutaneous coronary intervention), and coronary artery bypass. Among them, the insertion of stents into the coronary artery is one of the commonly used methods for CAD, although the formation of in-stent restenosis (ISR) is a major drawback, demanding improvement in stent technology. Stents can be improved using the delivery of DNA, siRNA, and miRNA rather than anti-inflammatory/anti-thrombotic drugs. In particular, genes that could interfere with the development of plaque around infected regions are conjugated on the stent surface to inhibit neointimal formation. Despite their potential benefits, it is necessary to explore the various properties of gene-eluting stents. Furthermore, multifunctional electronic stents that can be used as a biosensor and deliver drug- or gene-based on physiological condition will be a very promising way to the successful treatment of ISR. In this review, we have discussed the molecular mechanism of restenosis, the use of drug- and gene-eluting stents, and the possible roles that these stents have in the prevention and treatment of coronary restenosis. Further, we have explained how multifunctional electronic stents could be used as a biosensor and deliver drugs based on physiological conditions.

Keyword

Biosensing Techniques; Coronary Artery Disease; Coronary Restenosis; DNA; Drug-Eluting Stents

MeSH Terms

Angioplasty
Atherectomy, Coronary
Biosensing Techniques
Cause of Death
Coronary Artery Bypass
Coronary Artery Disease
Coronary Restenosis*
Coronary Vessels
DNA
Drug-Eluting Stents
MicroRNAs
RNA, Small Interfering
Stents*
DNA
MicroRNAs
RNA, Small Interfering

Figure

• 

  FIG. 1 (A) Coronary artery with restenosis, (B) coronary artery with ISR after stent implantation, and (C) a scheme representing the mechanisms of gene- and drug-eluting for preventing ISR. This illustration was conceived and drawn by Kamali ML.

• 

  FIG. 2 Micro-CT image of a BMS and HA-coated and miR145-loaded stents.86

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