Phosphorylcholine-coated stents

Stainless steel stents have been developed to perform their primary purpose of providing sufficient physical support to an artery following percutaneous transluminal coronary angioplasty (PTCA) in order to prevent vessel recoil. Early clinical problems, largely caused by subacute thrombosis (SAT), have been significantly reduced with a new generation of antiplatelet agents. Despite improved pharmacological control of SAT in many patients, the potential for stent occlusion remains a life-threatening problem for those with more complex lesions. One strategy for dealing with this is to improve the hemocompatibility of the stent surface with coatings. A phosphorylcholine (PC)-based stent coating has been designed for this purpose; we describe in detail the evaluation of the device, in vitro, through preclinical and early clinical data. We discuss studies that demonstrate that the PC-coated stent may offer some clinical advantage over uncoated counterparts. The extensive experience with this PC-coated device supports its nonthrombogenic nature, excellent acceptance by arterial tissue, and long-term stability in vivo. These characteristics, together with its ability to load and release a variety of therapeutic agents, also make the device a natural choice of platform for future stent-mediated drug delivery for treating restenosis.