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Intracoronary stents: a review of the experience with five different devices in clinical use
P P De Jaegere1, P J De Feyter, W J Van der Giessen
1Catheterization Laboratory, Thoraxcenter, University Hospital Rotterdam, The Netherlands.
Insights
Atherosclerosis treatments are evolving from surgery to less invasive methods like balloon angioplasty. New technologies, including coronary stents, aim to improve outcomes for obstructive coronary artery disease.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Biomedical Engineering
Background:
- Atherosclerotic cardiovascular disease is a leading cause of death globally.
- Current treatments for obstructive coronary artery disease include pharmacological intervention and revascularization.
- Surgical revascularization has been largely replaced by less invasive techniques due to patient needs for reduced morbidity and cost.
Purpose of the Study:
- To review the clinical experience and outcomes of various intracoronary stent types.
- To highlight advancements in interventional cardiology for treating atherosclerotic cardiovascular disease.
- To discuss the role of novel technologies in improving angioplasty results.
Main Methods:
- Review of clinical data on intracoronary stenting.
- Analysis of technological advancements in interventional cardiology.
- Evaluation of outcomes for percutaneous transluminal coronary angioplasty and adjunctive therapies.
Main Results:
- Percutaneous transluminal coronary balloon angioplasty is a widely accepted treatment for obstructive coronary artery disease.
- Abrupt vessel closure and restenosis remain challenges limiting angioplasty's efficacy.
- Intracoronary stenting, atherectomy, and laser therapy are leading edge technologies to improve angioplasty outcomes.
Conclusions:
- Intracoronary stenting and other novel technologies are crucial for enhancing the safety and efficacy of treating atherosclerotic cardiovascular disease.
- Continuous technological innovation is vital in interventional cardiology to overcome limitations of balloon angioplasty.
- Further research and clinical application of advanced devices are necessary to improve long-term patient outcomes.
Abstract:
Atherosclerotic cardiovascular disease remains one of the most important causes of morbidity and mortality in the industrialized world. Treatment is basically aimed at palliation and consists of either pharmacological intervention or revascularization. The first significant advances in the latter were largely surgical. However, the pressing need for treatment with less invasive and potentially less expensive techniques, have stimulated the development of nonsurgical revascularization techniques. Percutaneous transluminal coronary balloon angioplasty, which was first performed by Andreas Gruentzig in 1977, is one of the most successful examples and provided the stimulus for a rapid technological growth of interventional cardiology. It is now widely accepted as a safe and effective treatment of obstructive coronary artery disease. However, the risk of abrupt vessel closure during or immediately after the intervention and the risk of late luminal renarrowing or restenosis continue to compromise its overall safety and efficacy. To improve the immediate and long-term results of balloon angioplasty, a number of new technologies such as intracoronary stenting, directional or rotational atherectomy, and laser therapy have been developed and represent the leading edge in the battle against atherosclerosis. The purpose of this paper is to review the experience and results of the various types of stents in clinical use.