Intracoronary stents: will they fulfill their promise as an adjunct to angioplasty?

Department of Internal Medicine, University of Michigan Medical School, Ann Arbor.

Coronary angioplasty as it is now performed has several limitations, including abrupt early arterial closure and delayed restenosis. To obviate these problems and to enhance the safety of the technique, several intracoronary stenting devices have been developed and are under investigation. This report reviews the scientific rationale behind stenting, the results of stenting in animal models and the early results in humans. In early clinical investigation, restenosis appears uncommon but abrupt, presumably thrombotic, occlusion has been reported despite aggressive anticoagulation. As long as the potential for this problem remains and the long-term consequences of placing these devices into arteries of great functional importance remain unknown, stent placement must be undertaken with great caution and should be performed under carefully monitored circumstances with meticulous patient follow-up.