Over the past few years, the focus in interventional cardiology research has centered on reducing restenosis with the use of antiproliferative pharmacological agents. The use of these drugs, hitherto, has failed, most probably because of low active drug levels at the target site. This problem led to the development of local drug delivery using stents, since they can serve as a reservoir for local drug administration and are in immediate contract with the coronary artery wall, thus ensuring maximum delivery of the pharmacological agent. Drug-eluting stents provide an entirely new spectrum of potential therapies for restenosis.
Handbook of Drug-Eluting Stents, under the editorial direction of Patrick Serruys, one of the world's leading interventional cardiologists, and Tony Gershlick, a pioneer in the field of drug-eluting stents, provides the reader with up-to-date information on which stents and pharmacological agents in use or about to be launched, the kinetics of the drugs involved, and what the future may hold.
Table of Contents
1. Historical Notes of Early Failures and Later Successes with Local Drug Delivery 2. The Clinical Problem of Restenosis 3. Histopathology of Restenosis Cellular Mechanism of Restenosis, with Conventional Dogma And Novel Therapies 4. Molecular Basis of Restenosis: Potential Target and Agents for Local Drug Delivery 5. Principles and Kinetics of Stent-Based Drug Elution 6. Importance of the Toxic/Therapeutic Window 7. Importance of the Polymer 8. The Importance of the Drug Platform: Coated, Uncoated, Sleeves, and New Concepts 9. Cypher Programme of Cordis/Johnson & Johnson 10. Rapamycin Structures and Mechanism of Action 11. Rapamycin: Preclinical Studies 12. Non-Randomized Registries for De Novo Lesion (FIM) and Instent Restenosis 13. Randomized Trial (RAVEL) and Further Clinical Developments (SIRIUS) 14. Quanam Programme with Taxol Derivative (PILOT Study and SCORE Trial) 15. Taxus Programme of Boston Scientific 16. Paclitaxel Structures and Mechanism of Action 17. Preclinical Studies for the Taxus Programme 18. Non-Randomized Registries for De Novo Lesion (TAXUS I) and Instent Restenosis (TAXUSIII) 19. Randomized Trial (TAXUS II And IV) and Further Clinical Developments 20. The Cook Inc Paclitaxel Programme 21. Preclinical Studies 22. Clinical Programme 23. Aspect Patency Elutes and Future Studies 24. VEGF 25. The Guidant Actinomycin-D/Pharmalink Programme 26. Actinomycin Structures and Mechanisms of Action 27. Actinomycin: Preclinical Studies 28. Randomized Trial (ACTION, Europe; and OPEN USA) and Further Clinical Developments 29. The Biodivisio Programme 30. Angiopeptin: Mode of Action, Preclinical and Clinical Studies (SWAN) 31. Batimastat: Mode of Action, Preclinical and Clinical Studies (BRILLIANT)(BATMAN)(ROBIN)(DISTINCT) 32. Matrix Compounds 33. Dexamethasone: Mode of Action, Preclinical and Clinical Studies (STRIDE) 34. 17-Beta-Estradiol 35. Medtronic Programme 36. Antisense Oligonucleotides Against C-Myc (AVI4126 Biopharma): Current Status and Future 37. Developments 38. Orbus Programme of Eluting Stents 39. Igaki Tamai Programme 40. Biodegradable Stent (Tranilast and Inhibitors of Tyrosine Kinase) 41. Terumo Programme 42. Terumo Statin Releasing Stent (Preclinical Results) 43. JOMED Programme 44. Potential Agents in Development 45. Halofuginone, a Collagen Inhibitor