Antiproliferative stent coatings: Taxol and related compounds

The implantation of stents can prevent vessels from post interventional elastic recoil and appears to limit adverse remodelling. In order to inhibit in-stent restenosis, an additional release of antiproliferative agents from the stent itself might lead to a synergistic reduction of lumen renarrowing. Paclitaxel (Taxol) is a microtubule-stabilizing agent with potent antiproliferative activity. Unlike other antimitotic agents of the colchicine type, it shifts the microtubule equilibrium towards assembly, leading to reduced proliferation, migration and signal transduction. Moreover, important biological processes, such as the activation of some protein kinases, are associated with microtubule depolymerization and are therefore inhibited by paclitaxel. Several experimental in vitro and in vivo studies using local paclitaxel delivery to inhibit proliferation and lumen renarrowing have been performed already--with very encouraging results.