| Abstract: |
Percutaneous coronary balloon angioplasty was pioneered by Andreas Gruentzig who designed and assembled balloon dilatation catheters in his own kitchen. In 1976, he reported the successful application in canine coronary experiments. He performed the first successful coronary angioplasty in a patient in September 1977 in Zurich. Since then, remarkable refinement in the technology paved the way for emergence of new percutaneous coronary devices that include coronary atherectomy catheters, Laser and stents. The 1980’s and early 1990’s was primarily a balloon angioplasty era. Balloon angioplasty had two major limitations; restenosis which exceeded 50% in complex lesions, and acute vessel closure which though uncommon, resulted in major adverse events such as emergency CABG, myocardial infarction and death.In the mid 90’s, the application of coronary stenting emerged. Stents offer two distinct advantages over balloon angioplasty; they reduce the incidence of coronary dissections because of the scaffolding they create in the coronary artery and they reduce the incidence of restenosis by preventing acute recoil and achieving a bigger acute lumen diameter.Over the past two decades, an unlimited number of research studies sought to find a pharmacological solution to restenosis following balloon angioplasty or coronary stenting. These studies tested numerous agents that could alter one or more of multiple pathways that are believed to play a role in the restenosis process. Therefore, considerable efforts went into the development of stents that are coated by a polymer that can act as a reservoir for a particular pharmacologic agent and that can elute the drug at a pre-specified rate thus the concept of ”Drug Eluting Stents”
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