Abstract
Dutch researchers were among the first to perform clinical studies in bare metal coronary stents, the use of which was initially limited by a high incidence of in-stent restenosis. This problem was greatly solved by the introduction of drug-eluting stents (DES). Nevertheless, enthusiasm about first-generation DES was subdued by discussions about a higher risk of very-late stent thrombosis and mortality, which stimulated the development, refinement, and rapid adoption of new DES with more biocompatible durable polymer coatings, biodegradable polymer coatings, or no coating at all. In terms of clinical DES research, the 2010s were characterised by numerous large-scale randomised trials in all-comers and patients with minimal exclusion criteria. Bioresorbable scaffolds (BRS) were developed and investigated. The Igaki-Tamai scaffold without drug elution was clinically tested in the Netherlands in 1999, followed by an everolimus-eluting BRS (Absorb) which showed favourable imaging and clinical results. Afterwards, multiple clinical trials comparing Absorb and its metallic counterpart were performed, revealing an increased rate of scaffold thrombosis during follow-up. Based on these studies, the commercialisation of the device was subsequently halted. Novel technologies are being developed to overcome shortcomings of first-generation BRS. In this narrative review, we look back on numerous devices and on the DES and BRS trials reported by Dutch researchers.
Highlights
The introduction of bare metal stents (BMS) broadened the options for treating patients with obstructive coronary artery disease, which in the mid-1980s consisted of medical therapy, balloon angioplasty, or bypass surgery [1]
While we aimed at comprehensiveness of major randomised drug-eluting stents (DES) and Bioresorbable scaffolds (BRS) trials reported by Dutch researchers, we cannot exclude that an important study regrettably may not be mentioned
This review has shed a light on the Dutch contribution to clinical DES and BRS research during the 2010s
Summary
The 2010s in clinical drug-eluting stent and bioresorbable scaffold research: a Dutch perspective. J. de Winter · C. von Birgelen · P.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have