Coronary stents

Abstract

Coronary stent technology is a crucial part of most interventional procedures for percutaneous revascularization. Previously, vessel-wall injury and plaque fracture were the usual sequelae in response to the mechanical effect of balloon angioplasty. Nowadays, a sophisticated engineering tool serves not only as a scaffolding platform but also as an advanced vector for local antiproliferative drug delivery to the arterial wall. The wide acceptance of coronary stenting is based on the results of pioneering trials such as the BENESTENT and STRESS trials, which showed the superiority of stenting over balloon angioplasty in terms of a reduction in angiographic re-stenosis and the need for repeated intervention. Since then, the growing use of stents in ever more complex lesions and patients has stimulated the introduction of a rapidly increasing number of different stent designs. These have been proposed in order to address physiological concerns; indeed, a primary aim of stent development is to reduce device profiles and increase flexibility, thus facilitating safe delivery of the stent.