Drug-coated stents: preventing restenosis in coronary artery disease

Since its introduction in 1977, the success of percutaneous interventional cardiology has been limited by the occurrence of restenosis. Drug-eluting stents, particularly sirolimus- and paclitaxel-coated stents, have been shown in randomized controlled trials to dramatically reduce restenosis in single, de novo, native coronary arteries. Over the last 2 years, investigators have reported that these stents can also reduce restenosis in more complex patient situations such as in diabetics, during acute coronary syndromes, in long atherosclerotic lesions and small arteries, and even after in-stent restenosis. These outcomes increase the clinical value of this technology to "real world" practice. This article reviews the current state of our knowledge regarding drug-eluting stents and identifies areas for further research.