Percutaneous invasion of coronary arteries began with Andreas Gruentzig, who performed the first human percutaneous transluminal coronary angioplasty (PTCA). Stents, which overcame many of the limitations encountered with PTCA alone, were the next big milestone in the field of interventional cardiology. However, the incidence of restenosis even with stents remained high, at 20–40%. Over time, a...

Drug eluting stents have been implanted worldwide and used in nearly 90% of percutaneous coronary interventions in China. Although many randomized trials have confirmed the efficacy and safety profile of drug eluting stents, they were not powered to detect or exclude the effect of drug eluting stents on rare events such as stent thrombosis. Several mechanisms of very late stent thrombosis have ...

The majority of percutaneous coronary intervention cases are performed using drug eluting stents. Trials have consistently demonstrated lower rates of in stent restenosis and repeat revascularization with drug eluting stents when compared with bare metal stents. Stent technology has improved over the decade with changes in the thickness of stent struts, polymer coating and ease of stent deliver...

BACKGROUND Although significant undersizing often results in incomplete stent apposition or underexpansion, the possible impact of oversized stent implantation on arterial wall injury has not been systematically investigated with drug-eluting stents. The aim of this study was to investigate the impact of stent oversizing on acute and long-term outcomes after drug-eluting stents implantation in ...

BACKGROUND Preclinical evaluation of the vascular response of drug-eluting stents is limited especially in the setting of diabetes mellitus preventing the evaluation of changes in drug-eluting stent design and eluted drugs after clinical use. METHODS AND RESULTS Cultured human aortic endothelial cells were used to assess the differences between sirolimus and its analog, everolimus, in the set...

Everolimus-eluting stents (EES) represent the next generation of drug-eluting stents (DES). Important design modifications include thin strut stent backbones, less inflammatory and more biocompatible polymers, and lower drug dosing. The cobalt chromium EES fluoropolymer XIENCE V stent has been the most extensively studied of such stents. In animal models, this stent demonstrated minimal vessel ...

BACKGROUND Noncardiac surgery performed after coronary stent implantation is associated with an increased risk of stent thrombosis, myocardial infarction, and death. The influence of stent type and period of risk still have to be defined. METHODS AND RESULTS We linked the Scottish Coronary Revascularisation Register with hospital admission data to undertake a Scotland-wide retrospective cohor...

Drug-eluting stents reduce the occurrence of in-stent restenosis and the need for subsequent target vessel revascularization compared with bare-metal stents. However, the safety of drug-eluting stents has been called into question because of an apparent increase in late stent thrombosis, a frequently fatal event. A substantial body of research has focused on determining the magnitude of these c...

Drug-eluting stent release kinetics matter. This is demonstrated by the study of Guagliumi et al. (1) in this issue of JACC: Cardiovascular Interventions, which provides a description of the vascular responses to the next generation Resolute zotarolimus-eluting (sustained release) stent (Medtronic, Minneapolis, Minnesota). Vascular responses to this Resolute stent are compared with those of the...

The invention of the drug-eluting stent (DES) has brought about revolutionary changes in the field of interventional cardiology. In the DES era, in-stent restenosis has declined but new issues such as stent thrombosis have emerged. One of the emerging paradigms in the DES era is stent fracture. There are reports about stent fracture leading to in-stent restenosis or stent thrombosis. Most of th...