[Developments in percutaneous coronary intervention and coronary stents]

Area of Science:

• Cardiovascular Medicine
• Biomaterials Engineering
• Interventional Cardiology

Context:

• Over 30,000 percutaneous coronary interventions (PCI) occur annually in The Netherlands, with 90% involving coronary stent implantation.
• Globally, over 5 million coronary stent implantations are projected this year, highlighting the widespread use of these devices.
• Despite advancements, stent thrombosis remains a significant clinical limitation, necessitating ongoing research and development.

Purpose:

• To review the evolution of coronary stent technology, from bare metal stents to drug-eluting and bio-absorbable stents.
• To discuss the parallel development of anti-platelet therapies aimed at mitigating stent thrombosis.
• To explore the potential of novel, non-thrombogenic stent designs to reduce the duration of potent anti-platelet medication use.

Summary:

• Coronary stent implantation is a common procedure, but stent thrombosis is a persistent complication.
• The development trajectory includes bare metal, drug-eluting, and bio-absorbable stents, alongside evolving anti-platelet drugs.
• Non-thrombogenic stent development offers a pathway to potentially shorten anti-platelet therapy duration.

Impact:

• Reduced incidence of stent thrombosis and associated complications.
• Potential for decreased bleeding risks during invasive procedures (e.g., dental work) due to shorter anti-platelet therapy.
• Advancement in cardiovascular device technology and patient management strategies.