Effective and efficient strategies for coronary revascularization in the drug-eluting stent era

We now have at our disposal a variety of new technologies for percutaneous coronary revascularization, including drug-eluting stents (DES), intracoronary radiation therapy, and glycoprotein IIb/IIIa inhibitors. Coronary stents have improved both early and late outcomes following percutaneous coronary intervention. Stent characteristics including design, stent strut thickness, and stent metal alloy are associated with different rates of restenosis. This article reviews recent findings pertaining to the use of DES and other technologies for the treatment of coronary artery disease in diabetics and small vessel disease. The causes and treatment of in-stent restenosis are discussed. The optimal approach to coronary revascularization remains to be determined as brachytherapy, improvements in stent design, and new drug-eluting stents become available.