Literature Review On Atherosclerosis

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Literature Review Draft

Atherosclerosis is characterised by gradual decrease in the luminal diameter of large arteries, it has major health implications and contributes to around 50% of all deaths within westernized countries (7). Patients can undergo coronary artery stenting to prolong the effects of this. Treatments for this have undergone major developments over the past 40 years, including balloon angioplasty in 1977, development of bare-metal stents (BMS) in the 1980’s, introduction of drug-eluting stents (DES) in 2000 (43) and current research into incorporating NO donors into stents. The first stent implantation performed on a human was conducted in 1986 (13), since then they have become one of the most common ways of intervention due to atherosclerosis. In the US there are 500,000 people who undergo stenting annually (42). The success of stenting is inhibited by the reoccurrence of restenosis. Multiple things can affect the rate of in-stent restenosis, elevated LDL levels, increased levels of plasminogen activator inhibitor I, type 2 diabetes and enhanced platelet aggergability (10). Therefore the severity of restenosis will differ between patients.
Nobuyoshi et al, (1) and Serruys et al (2) found that restenosis is not an instantaneous development after stent implantation, it develops between the 1st and 3rd month after implantation, although the greatest change in luminal diameter occurred between the 2nd and 3rd month. These studies suggest that restenosis is
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