Evolution of Vascular Stents: Advances in Materials, Structural Design, and Clinical Translation

This study presents a systematic review and meta-analysis on the evolution of vascular stents, with a focus on their clinical applications, material development, and structural innovations. The historical trajectory of stent technology is first outlined, tracing the progression from bare-metal stents (BMS) to drug- eluting stents (DES), and more recently to biodegradable and bioactive regenerative stents. The clinical performance and limitations of these devices are critically assessed, particularly regarding in-stent restenosis, thrombosis risk, biocompatibility, and mechanical durability. Furthermore, key studies published in international journals and major databases since 2010 are analyzed to evaluate the advantages and shortcomings of representative stent materials, including metallic alloys and biodegradable polymers. Based on these findings, the study proposes design strategies balancing clinical performance and biocompatibility. Specific recommendations are provided to guide the optimization of novel materials and structural designs. These design recommendations are expected to translate into improved patient outcomes — for example reduced need for reintervention, faster functional recovery, and lower long-term complication rates. We anticipate this review will guide next-generation stent innovation and accelerate clinical translation toward devices that improve patient outcomes and reduce the need for reintervention.