Development and performance of the zotarolimus-eluting Endeavor®coronary stent

Given statistically significant and clinically meaningful reductions in angiographic restenosis and repeat revascularization, treatment with drug-eluting stents (DESs) has become established as a standard of care in percutaneous coronary revascularization. However, despite their superior efficacy compared with conventional bare metal stents, experiences with first-generation DESs from both clinical trials and real-world practice have raised attention to the late safety risk of stent thrombosis that may be related to biologic incompatibility, delayed vessel healing and/or impaired endothelial function. To address the outstanding needs related to DES safety and deliverability while maintaining efficacy, the Endeavor zotarolimus-eluting stent (Medtronic CardioVascular, CA, USA) is distinguished by favorable safety and efficacy demonstrated in clinical trials and usual practice. The purpose of this article is to describe the mechanical and pharmacologic features of the Endeavor stent, provide an overview of comparative trial results of the Endeavor stent with bare metal stents and alternative DESs, and detail recent and developing trials specific to the Endeavor stent that provide further insight to stent biocompatibility and safety.