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Updated: May 6, 2026
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Long-term safety of drug-eluting stents
Florian N Riede1, Matthias Pfisterer, Raban Jeger
1Division of Cardiology, University Hospital, Basel, Switzerland.
Insights
Drug-eluting stents (DES) have improved coronary artery disease treatment but can cause stent thrombosis (ST). This review explores DES, lesion anatomy, implantation, and pharmacology to minimize ST risk and optimize patient outcomes.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Biomaterials Science
Background:
- Coronary artery disease treatment advanced with stent implantation.
- Antirestenotic drug coatings on stents reduced revascularization rates.
- Drug-eluting stents (DES) introduced, leading to concerns about stent thrombosis (ST).
Purpose of the Study:
- To review the relationship between DES, lesion characteristics, implantation techniques, and pharmacology in preventing ST.
- To discuss dual antiplatelet therapy, bleeding risks, and patient outcomes.
- To highlight future strategies for improving DES safety.
Main Methods:
- Literature review focusing on studies investigating DES and ST.
- Analysis of factors influencing ST occurrence, including stent design and patient-specific variables.
- Examination of pharmacological strategies and antiplatelet therapy regimens.
Main Results:
- First-generation DES showed increased ST incidence compared to bare metal stents.
- Evolving DES designs, polymers, drugs, and antiplatelet regimens aim to mitigate ST risk.
- Balancing ST prevention with bleeding risk is crucial for optimal patient outcomes.
Conclusions:
- Optimizing DES implantation involves a multifactorial approach considering stent type, lesion complexity, technique, and pharmacology.
- Careful selection of dual antiplatelet therapy is essential to balance thrombosis prevention and bleeding complications.
- Ongoing research into novel DES technologies and therapeutic strategies promises enhanced safety and efficacy.
Abstract:
Stent implantation in coronary stenosis has revolutionized the treatment of coronary artery disease. The introduction of antirestenotic drug coatings further improved their efficacy in reducing target vessel revascularizations. With increasing use of drug-eluting stents (DES), stent thrombosis (ST) rose as potentially fatal major complication. Initially, the incidence of ST late after stent implantation seemed to be similar for DES and bare metal stents until several studies proved otherwise in first-generation DES. Since then, the design and components of DES have been changed and new polymers, drugs and different combinations of platelet inhibitors have been introduced to further improve the safety of DES. In this review, the authors focus on the relationship between DES, lesion anatomy, implantation technique and pharmacology to avoid the occurrence of ST. Furthermore, the relationship between dual antiplatelet therapy, bleeding rate and its significant impact on patient outcome is discussed. Finally, some promising future concepts are highlighted.
