Endovascular stents: update on stents in practice

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Biomedical Engineering

Background:

• Endovascular stent utilization in coronary angioplasty has surged, exceeding 50% of procedures.
• This rapid adoption is supported by positive in-hospital outcomes and limited long-term data from small trials.
• However, the generalized application of stents across all lesion types remains unsubstantiated.

Purpose of the Study:

• To review the current status of endovascular stent use in cardiovascular procedures.
• To identify the limitations associated with current stent designs and applications.
• To explore the potential of novel stent technologies in expanding endovascular interventions.

Main Methods:

• Review of current literature on endovascular stent use in coronary angioplasty.
• Analysis of clinical endpoints and in-hospital results from existing randomized trials.
• Examination of stent design limitations, including thrombosis, neointima proliferation, visibility, and deliverability.

Main Results:

• Stents are now used in over 50% of coronary angioplasty procedures.
• Existing trials supporting stent use have small patient subsets and limited stent designs.
• Key limitations include subacute thrombosis, late neointima proliferation, and design challenges.

Conclusions:

• While current stent use is high, generalized application needs further evidence.
• New stent designs, coatings, and bifurcation-specific stents are expected to enhance future endovascular procedures.
• Further research is necessary to validate the broad efficacy and safety of endovascular stents.