STENTS FOR INTRACORONARY PLACEMENT - CURRENT STATUS AND FUTURE-DIRECTIONS

The technique of intracoronary stenting has achieved remarkable progre ss over the last few years. Improved stent deployment techniques and o ptimization of postprocedural management have dramatically improved th e safety of intracoronary stent placement. At present, the incidence o f early vessel closure after stenting is even lower than that after st andard angioplasty and, as most operators no longer prescribe aggressi ve anticoagulation, bleeding complications are uncommon. Stenting has become an extremely effective treatment for abrupt or threatened vesse l closure or for any suboptimal angiographic result during conventiona l angioplasty. Furthermore, large prospective trials have demonstrated that its efficacy is superior to that of conventional angioplasty for primary restenosis prevention in focal lesions of some native coronar y arteries. Ongoing trials tend to extrapolate these conclusions to sa phenous vein graft lesions. Mechanical support of the vessel wall expl ains the sustained angiographic benefit observed after stenting. Futur e developments may include the use of stents as a vehicle for local dr ug delivery in an attempt to further reduce the incidence of restenosi s. In view of these results, coronary stents should be considered a ne w standard therapeutic modality in interventional cardiology.