[Coronary angioplasty: always a stent in arteries larger than 2.5 mm? The arguments con]

In the last 3 years there has been a tenfold increase in stent use during percutaneous coronary angioplasty. In many laboratories the prevailing strategy is to implant a stent whenever there are no contraindications to its use. The authors argue that this strategy of generalized stenting is not founded on solid scientific data, and that part of the actual growth in stent use is due to procedural reasons as simplicity, predictability and time economy. Accordingly they analyze the main trials comparing balloon angioplasty with elective stenting as well as the actual limitations and complications of stent use. Finally they point out alternative solutions to generalized stenting like the identification of subsets of patients who could benefit from stenting after balloon angioplasty (provisional stenting strategy).