Coronary Stenting

  • Trevor Simard
  • Juan J. Russo
  • Edward R. O’Brien
  • Benjamin Hibbert
Chapter

Abstract

Use of coronary stents as luminal scaffolds and drug delivery systems has revolutionized percutaneous coronary intervention. From their initial role as a bailout for angioplasty complications, coronary stents have evolved into the standard of care for obstructive coronary artery disease. Although early interventions were met with challenges related to abrupt vessel closure and restenosis, later use of bare-metal stents faced challenges related primarily to neointima formation and subsequent in-stent restenosis. The advent of first-generation drug-eluting stents limited the development of neointima, but were linked to stent thrombosis as a result of impaired vessel healing, triggering the continued refinement of stent technology. We discuss the relevant pathophysiologies of neointima formation and stent thrombosis as they pertain to stent development. In particular, we highlight key advancements in coronary stent development, ranging from the refinement of early bare-metal stents to drug-eluting stents with ever-advancing generations of antiproliferative agents, biocompatible polymers, and stent designs. Last, we touch on novel strategies for coronary stenting, including bioresorbable scaffolds and polymers, bifurcation stents, covered stents, and endothelial progenitor cell capture stents.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Trevor Simard
    • 1
    • 2
  • Juan J. Russo
    • 1
  • Edward R. O’Brien
    • 3
  • Benjamin Hibbert
    • 1
    • 2
  1. 1.CAPITAL Research Group, Division of CardiologyUniversity of Ottawa Heart InstituteOttawaCanada
  2. 2.Department of Cellular and Molecular MedicineUniversity of OttawaOttawaCanada
  3. 3.Division of CardiologyLibin Cardiovascular Institute of Alberta, University of CalgaryCalgaryCanada

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