A Contemporary Review of Coronary Artery Stents and Future Developments

Abstract

Cardiovascular diseases (CVDs), including coronary artery disease (CAD) are the leading cause of morbidity and mortality worldwide. CAD often relates to plaque build-up in arteries of heart. The optimal treatment of CAD still remains a topic of debate as, several trials scrutinizing the efficacy of two accepted approaches in CAD treatment namely, Percutaneus Coronary Intervention (PCI) with stenting, and Coronary Artery Bypass Grafting (CABG) have been published indicating increased rates of repeat vascularisation to be in association with PCI and major increase in rates of stroke to be associated with CABG. Previously, balloon angioplasty was also recommended tool for CAD treatment, however, balloon angioplasty no longer is a preferred choice due to higher incidence of arterial recoil, coronary dissection and neointima formation, ultimately leading to abrupt vessel closure and clinical restenosis. Although, with the advent of PCI, usage of coronary stents significantly reduces the chances of arterial recoil and stabilizes vascular dissections, the issues of neointimal thickening and in-stent restenosis still need to be addressed. To overcome this, coronary stents have evolved drastically in design, structure, and material. In recent times, drug-eluting stents have emerged as an attractive approach to combat these complications associated with stent implantation. Therefore, the aim of the present review is to discuss the recent developments in the field of coronary stents, which includes a detailed study about different types of metal stents and adverse outcomes occurring due to metal incompatibility. This review provides insights on stent incompatibility and the latest advances made to overcome stent metal incompatibility problems.