Three-dimensional Printing and Additive Manufacturing of Cardiovascular Stents: Current Advances, Biomaterials, Design Strategies, and Future Clinical Perspectives – A Narrative Review

Background: Cardiovascular stents have greatly improved the treatment of coronary and peripheral vascular disease. However, conventional stents still have limitations, particularly their standardized designs and limited ability to adapt to complex vascular anatomy and individual patient needs. Three-dimensional (3D) printing offers new possibilities for developing customized stents with greater control over their structure, materials, and therapeutic functions. Methods: This narrative review examined peer-reviewed studies identified through PubMed/MEDLINE, Scopus, and Web of Science, focusing mainly on research published between January 2019 and June 2026. The literature was qualitatively reviewed with particular attention to 3D-printing technologies, biomaterials, digital and patient-specific design, mechanical and biological performance, functional modifications, and challenges related to clinical translation. Of 45 identified records, 37 publications were included in the final synthesis. Results: Among the 37 included publications, 15 (40.5%) were in vitro studies, 8 (21.6%) were computational or virtual studies, 5 (13.5%) were animal studies, 3 (8.1%) were clinical or translational studies, and 6 (16.2%) were review or perspective articles. Current research shows that 3D printing can provide greater control over stent geometry, strut dimensions, lattice structure, porosity, and material distribution. Extrusion-based printing, photopolymerization, and metal additive manufacturing have been explored using polymeric, metallic, biodegradable, and composite materials. The integration of medical imaging, computer-aided design, and computational modeling also supports patient-specific stent development and mechanical optimization. However, most evidence remains preclinical, with important challenges involving mechanical durability, degradation control, hemocompatibility, manufacturing reproducibility, scalability, regulatory requirements, and limited long-term clinical evidence. Conclusion: 3D printing offers promising opportunities for developing more personalized and multifunctional cardiovascular stents. However, the technology remains at an emerging stage and has not yet demonstrated clear clinical superiority over established stent platforms. Further research is needed to improve materials and manufacturing processes and to establish long-term safety, efficacy, and clinical value through well-designed clinical studies.