PRACTICAL CLINICAL-EVALUATION OF STENTS

This article discusses the clinical issues pertaining to an optimal st enting result and analyzes relevant stent structures and functions. Th ere are five components of optimal stenting: favorable clinical featur es, easy stent delivery, ideal scaffolding, low stent thrombosis and l ow restenosis. In straight forward cases, such as stenting in the mid- right coronary artery with a straight proximal segment, procedural suc cess can be achieved with any stent. In vessels with curved, tortuous proximal segments, a highly flexible stent is needed for a smooth and successful delivery. For ostial, protected left main, or aortoanastomo tic lesions, stents with sufficient radial strength and good visibilit y are needed. The two major concerns of an interventional cardiologist choosing a stent are excellent trackability for fast delivery and low long-term restenosis rate. In all situations, the procedural success depends on the operator's manual dexterity, experience with a particul ar stent design, and critical evaluation of different structural stent features to maximize benefits. Any new stent with high longitudinal f lexibility, excellent scaffolding and radial strength, adequate radiop acity, complete deployment after one inflation, and that is easily rec rossed and provides a good symmetrical conduit for a smooth coronary f low resulting in little tendency for thrombosis or restenosis would be today's stent of choice.