Challenges and Caveats for Stents of New Technology: Which Stent is Better? What are the Results in High-risk Patients?

Coronary stenting has revolutionized percutaneous coronary revascularization. Two landmark studies published in 1994, Benestent and STRESS, demonstrated the significantly superior outcomes of intracoronary stenting versus balloon angioplasty. However, the success of bare-metal stents was limited by the occurrence of neointimal hyperplasia (NIH) leading to in-stent restenosis (ISR). The problem of neointimal hyperplasia, as measured by late loss, represented a significant hurdle, limiting the long-term patency of stents in many patient populations. The solution to the problem of ISR (the Achilles heel of the stent) was given by the evolution of new stent platforms coated with polymers eluting anti-proliferative drugs, drug eluting stents-DES... (excerpt