[More than 25 years of coronary stent implantation]

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology

Context:

• Approximately 38,000 percutaneous coronary interventions (PCI) are performed annually in the Netherlands.
• Stent implantation occurs in about 90% of these PCI procedures.
• PCI is primarily used for acute coronary syndrome, with decreasing use for stable coronary disease.

Purpose:

• To assess the increasing accessibility of PCI for complex stenoses due to technological advancements.
• To determine the optimal combination of stent type and antiplatelet therapy for improved treatment durability.
• To inform clinical decisions regarding stent implantation through a combination of functional and anatomical stenosis measurements.

Summary:

• Modern coated stents significantly enhance treatment durability, with only 7% requiring repeat procedures within a year.
• Innovations in techniques and equipment are expanding the applicability of PCI to complex stenoses previously treated with coronary bypass surgery.
• Informed decisions on stent implantation necessitate integrating both functional and anatomical stenosis assessments.

Impact:

• Improved patient outcomes through more durable PCI treatments.
• Reduced need for coronary bypass surgery for complex stenoses.
• Ongoing clinical studies aim to optimize stent selection and antiplatelet regimens for percutaneous coronary intervention.