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MINERVA CARDIOANGIOLOGICA

A Journal on Heart and Vascular Diseases


Official Journal of the Italian Society of Angiology and Vascular Pathology
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Minerva Cardioangiologica 2009 October;57(5):629-44

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Endothelial dysfunction after drug eluting stent implantation

van den Heuvel M. 1, 2, Sorop O. 1, van Beusekom H. M. M. 1, van der Giessen W. J. 1, 3

1 Department of Cardiology, Cardiovascular Research School COEUR, Erasmus Medical Center, Rotterdam, The Netherlands; 2 Division of Pharmacology, Vascular and Metabolic Diseases, Department of Internal Medicine, Cardiovascular Research School COEUR, Erasmus Medical Center, Rotterdam, The Netherlands; 3 Interuniversity Cardiology Institute of the Netherlands, ICIN-KNAW, Utrecht, The Netherlands


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Endothelial dysfunction has been implicated in the pathological process of coronary artery disease as well as an adverse event after coronary drug eluting stent (DES) implantation. In this review, an overview will be given of the evidence to date regarding the effects of coronary DES on endothelial function obtained from both clinical and experimental studies. Stenting in general and DES seem to impair several aspects of endothelial function: provision of a permeable barrier function; modulation of adhesion, thrombosis and inflammation; and regulation of vascular tone. However, new insights show that the effects of DES can extend beyond the stent and peri-stent area: the vascular bed distal to the stent, starting with the distal conduit vessels up to the distal microvasculature, might be at risk. In addition, insight into the mechanism of DES induced endothelial dysfunction has been gained. To finalize this review, clinical complications and solutions of DES associated endothelial dysfunction will be discussed.

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w.j.vandergiessen@erasmusmc.nl