Safety of drug-eluting stents

Significant evolution in catheter-based technologies for percutaneous coronary intervention has occurred since the introduction of coronary balloon angioplasty by Andreas Grüntzig in 1977. As balloon angioplasty was supplanted by bare metal stents and subsequently drug-eluting stents (DES), randomized comparative clinical trials have demonstrated a progressive decline in both angiographic and clinical restenosis with each technologic iteration. Following widespread clinical use of DES, multiple safety issues have been identified in late follow-up that have prompted efforts toward development of bioresorbable polymers and polymer-free metal platforms, as well as completely resorbable DES platforms. The ultimate goal of these efforts is to provide safe and durable coronary patency. The promise of bioresorbable DES platforms includes the additional benefits of recovery in normal autoregulatory as well as microvascular function, the capacity for late luminal enlargement/expansive remodeling, and the potential for reducing the requirement for prolonged dual antiplatelet therapy.