Evolution of Coronary Stents: From Birth to Future Trends

Coronary artery disease (CAD) remains one of the leading causes of mortality worldwide, affecting more than 300 million people. Over the past two decades, percutaneous coronary intervention (PCI) has become the cornerstone of CAD treatment, involving the implantation of coronary stents. This review clarifies how coronary stents emerged, evolved, and ultimately reshaped modern interventional cardiology. Beginning with balloon angioplasty and progressing through bare-metal and drug-eluting stents, we show how each advancement solved key clinical shortcomings—dramatically reducing restenosis, thrombosis, and repeat revascularization. We further review the major technological advances driving modern stent development, such as biodegradable alloys and biomimetic coatings. We also highlight the remaining challenges, including long-term stability, manufacturing complexity, and limited translational readiness. Together, these elements support our central thesis: that the historical evolution of coronary stents is fundamental to understanding present PCI practice and to guiding the next phase of device innovation.