Drug-eluting Stents

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The Newest Generation of Drug-eluting Stents and Beyond

When Andreas Grüntzig introduced balloon coronary angioplasty in 1977 it represented the first alternative to coronary artery bypass graft surgery. However, balloon dilatation had inherent limitations – including elastic recoil and vessel closure in the acute phase, as well as negative remodelling and restenosis in the late phase – which limited its applicability and further expansion. In the 1980s, bare metal stents (BMS) rapidly demonstrated superiority over balloon angioplasty, improving angiographic results and clinical outcomes.

Challenges in Patients with Diabetes: Improving Clinical Outcomes After Percutaneous Coronary Intervention Through EVOlving Stent Technology

Newer generation polymeric metallic drug-eluting stents (DES) have shown improved efficacy and safety compared with bare-metal stents and first-generation DES, improving patient outcomes after percutaneous coronary intervention (PCI) and facilitating the treatment of more complex coronary disease.1 However, clinical outcomes in certain lesion and patient subsets remain suboptimal. Procedural and/or technological refinements may improve success rates in such scenarios.

Current State of the Art in Approaches to Saphenous Vein Graft Interventions

Saphenous vein grafts (SVGs) are commonly used during coronary artery bypass graft surgery (CABG) for severe coronary artery disease. However, SVGs are prone to both degeneration and occlusion, leading to poor long-term patency compared with arterial grafts. Previous reports suggest rates of SVG failure in the first 12–18 months may be as high as 25 %.1–4 SVG neointimal hyperplasia and accelerated atherosclerosis diminish the long-term benefits of CABG, while subsequent SVG interventions are plagued by plaque embolisation and no-reflow phenomenon.