Skip to main content

Case Study: Drug Eluting Stent

  • Chapter
  • First Online:
Controlled Drug Delivery Systems

Part of the book series: SpringerBriefs in Applied Sciences and Technology ((BRIEFSPOLIMI))

  • 1134 Accesses

Abstract

In drug eluting stent technologies, an increased demand for better control, higher reliability and enhanced performances of drug delivery systems emerged in the last years and thus offered the opportunity to introduce model-based approaches aimed to overcome the remarkable limits of trial–and-error methods. In this context a chemical engineering approach was studied, being based on the detailed conservation equations and taking into account the main physical–chemical mechanisms involved in polymeric coating degradation, drug release and restenosis inhibition. It allowed highlighting the interdependence between factors affecting each of these phenomena and, in particular, the influences of stent design parameters on drug antirestenotic efficacy. The hierarchical structure of this model also allows easily modifying the set of equations describing restenosis evolution in order to enhance model reliability and taking advantage of the deep understanding of physiological mechanisms governing the different stages of smooth muscle cell growth and proliferation. In addition, thanks to its simplicity and to the very low system requirements and CPU time, our model allows obtaining immediate views of system behavior.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 44.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 59.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Bagust, A., Grayson, A. D., Palmer, N. D., Perry, R. A., & Walley, T. (2006). Cost effectiveness of drug eluting coronary artery stenting in a UK setting: cost-utility study. Heart, 92, 68–74.

    Article  Google Scholar 

  • Dawkins, K. D., Grube, E., Guagliumi, G., Banning, A. P., Zmudka, K., Colombo, A., 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, 3306–3313.

    Article  Google Scholar 

  • Finkelstein, A., McClean, D., Kar, S., Takizawa, K., Varghese, K., Baek, N., et al. (2003). Local drug delivery via a coronary stent with programmable release pharmacokinetics. Circulation, 107, 777–784.

    Article  Google Scholar 

  • Franks, S. J., Byrne, H. M., King, J. R., Underwood, J. C. E., & Lewis, C. E. (2003a). Modelling the early growth of ductal carcinoma in situ of the breast. Journal of Mathematical Biology, 47, 424–452.

    Article  MATH  MathSciNet  Google Scholar 

  • Franks, S. J., Byrne, H. M., King, J. R., Underwood, J. C. E., & Lewis, C. E. (2003b). Modelling the early growth of ductal carcinoma in situ of the breast. Journal of Mathematical Biology, 47, 424–452.

    Article  MATH  MathSciNet  Google Scholar 

  • Kastrati, A., Dibra, A., Eberle, S., Mehilli, J., de Lezo, J. S., Goy, J. J., et al. (2005). Sirolimus-eluting stents vs paclitaxel-eluting stents in patients with coronary artery disease—Meta-analysis of randomized trials. JAMA, 294, 819–825.

    Article  Google Scholar 

  • Lemos, P. A., Serruys, P. W., & Sousa J. E. (2003). Drug-eluting stents. Cost vs clinical benefit. Circulation, 107, 3003–3007.

    Google Scholar 

  • Levin, A. D., Vukmirovic, N., Hwang, C. W., & Edelman, E. R. (2004). Specific binding to intracellular proteins determines arterial transport properties for rapamycin and paclitaxel. Proc. Natl Acad. Sci. U S A, 101, 9463–9467.

    Article  Google Scholar 

  • McFadden, E. P., Stabile, E., Regar, E., Cheneau, E., Ong, A. T. L., Kinnaird, T., et al. (2004). Late thrombosis in drug-eluting coronary stents after discontinuation of antiplatelet therapy. Lancet, 364, 1519–1521.

    Article  Google Scholar 

  • Ong, A. T. L., Serruys, P. W., Aoki, J., Hoye, A., van Mieghem, C. A. G., Rodriguez-Granillo, G. A., et al. (2005). The unrestricted use of paclitaxel-versus sirolimus-eluting stents for coronary artery disease in an unselected population—One-year results of the Taxus-Stent Evaluated At Rotterdam Cardiology Hospital (T-SEARCH) registry. Journal of the American College of Cardiology, 45, 1135–1141.

    Article  Google Scholar 

  • Scheller, B., Speck, U., Schmitt, A., Bohm, M., & Nickenig, G. (2003). Addition of paclitaxel to contrast media prevents restenosis after coronary stent implantation. Journal of the American College of Cardiology, 42, 1415–1420.

    Article  Google Scholar 

  • Schwartz, R. S., Chronos, N. A., & Virmani, R. (2004). Preclinical restenosis models and drug-eluting stents - Still important, still much to learn. Journal of the American College of Cardiology, 44, 1373–1385.

    Google Scholar 

  • Serruys PW and Gershlick A (2005) In Handbook of Drug-Eluting Stents. Vol. pp. CRC Press, New York,

    Google Scholar 

  • Sousa, J. E., Costa, M. A., Abizaid, A., Abizaid, A. S., Feres, F., Pinto, I. M. F., et al. (2001). Lack of neointimal proliferation after implantation of sirolimus-coated stents in human coronary arteries—A quantitative coronary angiography and three-dimensional intravascular ultrasound study. Circulation, 103, 192–195.

    Article  Google Scholar 

  • Sousa, J. E., Serruys, P. W., & Costa, M. A. (2003). New frontiers in cardiology—Drug-eluting stents: Part II. Circulation, 107, 2383–2389.

    Article  Google Scholar 

  • Steigerwald, K., Merl, S., Kastrati, A., Wieczorek, A., Vorpahl, M., Mannhold, R., et al. (2009). The pre-clinical assessment of rapamycin-eluting, durable polymer-free stent coating concepts. Biomaterials, 30, 632–637.

    Article  Google Scholar 

  • Stone, G. W., Ellis, S. G., Cox, D. A., Hermiller, J., O’Shaughnessy, C., Mann, J. T., et al. (2004a). One-year clinical results with the slow-release, polymer-based, paclitaxel-eluting TAXUS Stent the TAXUS-IV trial. Circulation, 109, 1942–1947.

    Article  Google Scholar 

  • Stone, G. W., Ellis, S. G., Cox, D. A., Hermiller, J., O’Shaughnessy, C., Mann, J. T., et al. (2004b). A polymer-based, paclitaxel-eluting stent in patients with coronary artery disease. New England Journal of Medicine, 350, 221–231.

    Article  Google Scholar 

  • Tanimoto, S., Daemen, J., Tsuchida, K., Garcia-Garcia, H. M., de Jaegere, P., van Dornburg, R. T., et al. (2007). Two-year clinical outcome after coronary stenting of small vessels using 2.25-mm sirolimus- and paclitaxel-eluting stents: Insight into the RESEARCH and T-SEARCH registries. Catheterization and Cardiovascular Interventions, 69, 94–103.

    Article  Google Scholar 

  • Togni, M., Eber, S., Widmer, J., Billinger, M., Wenaweser, P., Cook, S., et al. (2007). Impact of vessel size on outcome after implantation of sirolimus-eluting and paclitaxel-eluting stents—A subgroup analysis of the SIRTAX trial. Journal of the American College of Cardiology, 50, 1123–1131.

    Article  Google Scholar 

  • Venkatraman, S., & Boey, F. (2007). Release profiles in drug-eluting stents: Issues and uncertainties. J. Control. Release, 120, 149–160.

    Article  Google Scholar 

  • Virmani, R., Guagliumi, G., Farb, A., Musumeci, G., Grieco, N., Motta, T., et al. (2004). Localized hypersensitivity and late coronary thrombosis secondary to a sirolimus-eluting stent should we be cautious? Circulation, 109, 701–705.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Filippo Rossi .

Rights and permissions

Reprints and permissions

Copyright information

© 2016 The Author(s)

About this chapter

Cite this chapter

Rossi, F., Perale, G., Masi, M. (2016). Case Study: Drug Eluting Stent. In: Controlled Drug Delivery Systems. SpringerBriefs in Applied Sciences and Technology(). Springer, Cham. https://doi.org/10.1007/978-3-319-02288-8_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-02288-8_5

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-02287-1

  • Online ISBN: 978-3-319-02288-8

  • eBook Packages: EngineeringEngineering (R0)

Publish with us

Policies and ethics