Nanoplasty and Nanotechnology in Stenting of the Heart a Narrative Review of Advances in Coronary Interventions

Coronary artery disease remains the leading cause of mortality worldwide, and percutaneous coronary intervention with stent implantation has revolutionized its management. Despite significant advancements from bare metal stents to drug-eluting stents, challenges such as in-stent restenosis, delayed endothelialization, and late stent thrombosis persist. Nanotechnology offers promising solutions through nanoparticle-based drug delivery systems, nanocoatings, and molecular targeting strategies that may achieve restenosis prevention while preserving endothelial healing. This narrative review examines the evolution of coronary stent technology, the pathophysiology of in-stent restenosis, and the application of nanotechnology in contemporary stent design. We discuss various nanoparticle platforms including liposomes, polymeric nanoparticles, and magnetic nanoparticles, along with their mechanisms of targeted drug delivery to the vascular wall. Furthermore, we review preclinical studies and early clinical trials of nanoparticle-enhanced stents, analyze current challenges in clinical translation, and outline future directions for this rapidly evolving field.