Coronary stents: Impact on modern interventional practice

SummaryThere has been a rapid increase in coronary-stent placement as part of routine coronary angioplasty in the last few years. There are many reasons for this, including rapid developments in stent and balloon technology, which have resulted in low-profile, securely balloon-mounted stents, facilitating placement in complex coronary lesions. The indications for stent placement have been widened so that not placing a stent takes place in only a significant minority of procedures. In many centres stent placement accompanies > 70% of coronary angioplasty procedures. New developments in stent technology, including covered stents, coated stents and stents for particular uses, such as bifurcation lesions, continue to expand the indications for this type of angioplasty technology. The increased use of stents has been facilitated by the introduction of effective new antiplatelet drugs, which have reduced the need for systemic anticoagulation of stented patients. There are strong indications that stent placement affects the natural history of restenosis following angioplasty, significantly reducing the incidence of this condition.