The Drug-Eluting Stent

The First-Generation with a Durable Polymer: Cypher and Taxus

Most of the studies carried out to test systemic antiproliferative drugs as a means to fight neointimal hyperplasia had failed. We thus tried to inhibit smooth-muscle cell proliferation in situ through a platform based on a cytostatic mechanism. It is here that we would begin to see that this method resulted in delayed endothelialization.

2.1 - The two families of antiproliferative agents

Sirolimus was isolated from a bacterium found on Easter Island in 1965. Initially called rapamycin (from Rapa Nui, the local name of Easter Island), it was originally used as an antifungal antibiotic. Randall Morris discovered its immunosuppressive activity in 1988. Sirolimus affects intimal hyperplasia by inhibiting lymphocyte and smooth muscle cell proliferation. Robert Falotico, leader of the Stent Therapeutic Team (created in 1996 at Cordis), was mandated to develop this revolutionary technology: deliver a drug from a stent that, at the same time, could eliminate the problem of systemic toxicity and side effects. The difficulty was in finding the right drug and in developing a coating for the stent. Sirolimus was selected after a systematic drug screening process that included 800 different drugs, something that was made possible by collaborative...