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2006, Número 3

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Arch Cardiol Mex 2006; 76 (3)


Stents liberadores de fármacos

García-García HM, Vaina S, Tsuchida K, Serruys PW

Idioma: Ingles.
Referencias bibliográficas: 104
Paginas: 297-319
Archivo PDF: 394.51 Kb.


RESUMEN

Mejoras ulteriores, como la elevación de la capacidad de carga de los fármacos, su revestimiento con capacidad farmacocinética programable y la preparación de nuevos fármacos, podrían aumentar a futuro la eficacia y la seguridad de los stents liberadores de fármacos. Aunque dichos stents han reducido de manera significativa el número de reestenosis angiográficas y mejorado el resultado clínico, la trombosis tardía y la reestenosis quedan como temas importantes de investigaciones futuras. Puesto que los stents liberadores de fármacos se utilizan en toda lesión, se necesitan agentes más eficaces y mejores estructuras de tales instrumentos. Pueden utilizarse polímeros sintéticos o biológicos como matrices para incorporar los fármacos, pero han surgido preocupaciones acerca de la biocompatibilidad, la esterilidad y la capacidad potencial de inducir inflamación. Habitualmente se examinan posibles alteraciones del diseño estructural del stent (biodegradable, bioabsorbible, nanoporoso, etc.). Los compuestos antiproliferativos sirolimus y paclitaxel han dominado claramente la práctica clínica hasta la fecha, mientras que sus análogos están apareciendo prontamente. No obstante es probable que, a futuro, los fármacos actualmente sometidos a investigación, intervengan sobre mecanismos asociados con modelación de la capa neoíntima que lleva a la reestenosis. Éstos podrían actuar por sí solos o en combinación con los compuestos antiproliferativos ya mencionados.


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