Management and outcome of stents in 1998: long-term outcome

In the first 20 years of its existence, percutaneous transluminal coronary angioplasty (PTCA) has emerged to become the most common major medical intervention. In the meantime, many different adjunctive devices, such as drills, lasers, cutters, and suckers, have been invented, but only stents (introduced in 1986) have become a major asset to PTCA. Their main benefit is reducing the incidence of acute occlusions caused by dissection and, thus, the need for emergency bypass grafting. The approximate 30% restenosis rate of PTCA between 3 and 6 months after the intervention is also reduced to approximately 20% by stents. In the long term, ie, after 6 months, the stented or nonstented lesion is stable and needs a revascularization procedure in only 4% of the lesions. After PTCA, progression of coronary artery disease plays a dominant role, necessitating subsequent interventions for new stenoses in as many as 10% of patients.