Medikamente freisetzende koronarstents und mit medikamenten beschichtete ballonkatheter: Positionspapier der DGK 2011

The Position Paper of the German Cardiac Society on drug-eluting stents (DES) and drug-coated balloon catheters (DCB) focuses on products which are approved for use and are available in Germany after successful investigation in clinical trials. Randomized, controlled clinical trials with the primary angiographic endpoint of providing evidence for antirestenotic efficacy should be required for all products as well as subsequent clinical endpoint trials. The use of DES in comparison to bare metal stents (BMS) leads to reduction of repeat revascularizations, while the clinical endpoints such as death or myocardial infarction remain unchanged. DES should be preferred in cases of increased risk for in-stent stenosis (ISR). In cases of elevated risk for stent thrombosis or expected problems of prolonged dual antiplatelet therapy, preference should be given to the use of BMS. The duration of dual antiplatelet therapy should be 1 month after BMS implantation, 1 month after treatment of BMS ISR with DCB, and 6-12 months after DES implantation in all patients and as a matter of principle 12 months after acute coronary syndrome (ACS) irrespective of the type of intervention.