Key result
Coronary stent design has evolved from bare-metal to drug-eluting and bioabsorbable scaffolds to address limitations like in-stent restenosis and late stent thrombosis.
This review summarizes the evolution of coronary stent design from bare-metal to drug-eluting and bioabsorbable scaffolds, highlighting the balance between restenosis and stent thrombosis.
Stent evolution review contextualizes device selection; leaves open optimal platforms minimizing both restenosis and thrombosis.
Coronary stent implantation is the standard of care in percutaneous coronary interventions, offering a better outcome in the short and long term. The main limitation of bare-metal stents is in-stent restenosis resulting from neointimal hyperplasia, associated with a substantial rate of target lesion revascularization. Drug-eluting stents reduced in-stent restenosis and repeat revascularization; however, late stent thrombosis has been the main concern with regards to this technology. Chronic inflammatory and hypersensitivity reactions to the polymer of drug-eluting stents were implicated in the predisposition to stent thrombosis. Second-generation drug-eluting stents with biocompatible and biodegradable polymers promised a better safety outcome. Moreover, studies on novel antiproliferative and polymer-free drug-eluting stents demonstrated at least comparable angiographic late loss. Early-phase studies on bioabsorbable vascular scaffolds demonstrated substantial late loss: a combination of neointimal hyperp...
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Karjalainen et al. (2014) conducted a review in Percutaneous coronary interventions. Coronary stents was evaluated. Coronary stent design has evolved from bare-metal to drug-eluting and bioabsorbable scaffolds to address limitations like in-stent restenosis and late stent thrombosis.
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