One step forward and two steps back with drug-eluting-stents: from preventing restenosis to causing late thrombosis and nouveau atherosclerosis.

Percutaneous coronary intervention with intracoronary stenting is the most widely performed procedure for the treatment of symptomatic coronary disease ([1][1]). Although drug-eluting stents (DES) have minimized the major limitation of bare-metal stents (BMS), i.e., restenosis, stent thrombosis has

[1]  Michael Joner,et al.  Pathology of drug-eluting stents in humans: delayed healing and late thrombotic risk. , 2006, Journal of the American College of Cardiology.

[2]  R. Virmani,et al.  Ultrasonic and pathological evidence of a neo-intimal plaque rupture in patients with bare metal stents. , 2007, EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology.

[3]  Michael Joner,et al.  Vascular Responses to Drug Eluting Stents: Importance of Delayed Healing , 2007, Arteriosclerosis, thrombosis, and vascular biology.

[4]  A. Hirayama,et al.  Assessment of plaque vulnerability by angioscopic classification of plaque color. , 2004, American heart journal.

[5]  R. Virmani,et al.  Lessons from sudden coronary death: a comprehensive morphological classification scheme for atherosclerotic lesions. , 2000, Arteriosclerosis, thrombosis, and vascular biology.

[6]  Seiki Nagata,et al.  Incomplete neointimal coverage of sirolimus-eluting stents: angioscopic findings. , 2006, Journal of the American College of Cardiology.

[7]  Giulio Guagliumi,et al.  Optical coherence tomography: High resolution intravascular imaging to evaluate vascular healing after coronary stenting , 2008, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[8]  M. Hori,et al.  Serial Angioscopic Evidence of Incomplete Neointimal Coverage After Sirolimus-Eluting Stent Implantation: Comparison With Bare-Metal Stents , 2007, Circulation.

[9]  K. Kodama,et al.  Atherosclerotic and thrombogenic neointima formed over sirolimus drug-eluting stent: an angioscopic study. , 2009, JACC. Cardiovascular imaging.

[10]  Jon C. Aster,et al.  Robbins BASIC PATHOLOGY , 2002, Robbins Basic Pathology.

[11]  Masanori Yamamoto,et al.  Evaluation by optical coherence tomography of neointimal coverage of sirolimus-eluting stent three months after implantation. , 2007, The American journal of cardiology.

[12]  R. Virmani,et al.  Extracellular Matrix Changes in Stented Human Coronary Arteries , 2004, Circulation.

[13]  B. Berk,et al.  Laminar shear stress: mechanisms by which endothelial cells transduce an atheroprotective force. , 1998, Arteriosclerosis, thrombosis, and vascular biology.

[14]  Hiromasa Otake,et al.  Neointimal coverage of sirolimus-eluting stents at 6-month follow-up: evaluated by optical coherence tomography. , 2007, European heart journal.

[15]  R. Virmani,et al.  Pathological Correlates of Late Drug-Eluting Stent Thrombosis: Strut Coverage as a Marker of Endothelialization , 2007, Circulation.

[16]  M. Hori,et al.  The healing process of infarct-related plaques. Insights from 18 months of serial angioscopic follow-up. , 2001, Journal of the American College of Cardiology.

[17]  W Rutsch,et al.  A comparison of balloon-expandable-stent implantation with balloon angioplasty in patients with coronary artery disease. Benestent Study Group. , 1994, The New England journal of medicine.

[18]  Serial long-term evaluation of neointimal stent coverage and thrombus after sirolimus-eluting stent implantation by use of coronary angioscopy , 2007, Heart.

[19]  K. Kodama,et al.  Neointimal coverage of stents in human coronary arteries observed by angioscopy. , 1994, Journal of the American College of Cardiology.