ABSTRACT
Background The advent of drug-eluting stents (DES) and their clinical success has brought about a paradigm shift in the treatment of occlusive coronary artery disease. Prior to the introduction of DES, the restenosis rate in patients who had undergone coronary stenting or balloon angioplasty varied between 20% and 50%, depending on the complexity of the lesion and the patient subset being treated (1-3). The use of DES has offered an elegant and effective de novo therapeutic approach to addressing the major components of postangioplasty restenosis, negative remodeling, and neointimal hyperplasia, while potentially minimizing the risk of systemic toxicity by potent therapeutic agents (4). This chapter provides an overview of the restenotic cascade-the arch enemy of percutaneous coronary intervention (PCI)—a summary of pharmacologic therapies investigated for the prevention of restenosis both prior to and during the DES era, and a discussion of antiproliferative and antimigratory compounds used as part of DES systems, using the TAXUS®
DES (Boston Scientific Corporation, Natick, Massachusetts, U.S.A.) as an example.
