STENTS - WHERE ARE WE GOING

The increasing frequency of stent implantation into coronary arteries is based mainly on assumptions. One of these assumptions is that stent s may prevent restenosis. Stents can prevent restenosis as has been sh own in two randomized studies (Stress I and Benestent I), but only in large (> 3.0 mm) vessels with short denovo lesions. Despite the very t ight selection of patients suitable for stent implantation in these tw o studies, the advantage for stents remained small (about 10% less res tenosis) and appeared to decrease with time following intervention. Th ere is increasing concern about the extension of stenting in an ''unre stricted strategy''. This concern was expressed in the ACC Expert Cons ensus Document which was published recently (JACC 28, No 3, September 1996: 782-794). Based on lack of data for most of the presently used s tent indications the expert group recommended a more selective strateg y for the implantation of stents into coronary arteries.