Long-term patient benefit with biodegradable polymer biolimus eluting stent

The introduction of bare metal stents in the early 1990 and of 1st generation drug eluting stents (DES) in the early 2000 defined a new era in interventional cardiology. DES dramatically reduced instant restenosis and the need of revascularization after percutaneous coronary intervention. However, this increased efficacy came at the cost of delayed vascular healing and subsequent late adverse event such as late stent thrombosis. Second generation DES appears even more efficient and safer than 1st generation DES, providing exciting perspectives for the near future. A new era has started with the development of bio-absorbable polymers. Biodegradable polymer eluting stents, such as the biolimus A9 eluting stent showed non-inferiority to durable polymer sirolimus eluting stent and, by reducing the risk of cardiac events associated with very late stent thrombosis, might improve long-term clinical outcomes in a variety of patients including chronic stable coronary artery disease and acute coronary syndromes. Biodegradable polymer DES are more likely to define the 3rd generation DES. The goal of future development is to further increase safety and efficacy of DES.