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STATE-OF-THE-ART PAPER

Coronary Stents

Current Status

Department of Interventional Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands

Manuscript received December 9, 2009; revised manuscript received June 1, 2010, accepted June 15, 2010.

^_* Reprint requests and correspondence: Dr. Patrick W. Serruys, Department of Interventional Cardiology, Ba583a, Thoraxcenter, Erasmus Medical Center, 's-Gravendijkwal 230, Rotterdam 3015 CE, the Netherlands (Email: p.w.j.c.serruys{at}erasmusmc.nl).

Coronary artery stents revolutionized the practice of interventional cardiology after they were first introduced in the mid-1980s. Since then, there have been significant developments in their design, the most notable of which has been the introduction of drug-eluting stents. This paper reviews the benefits, risks, and current status of Food and Drug Administration-approved drug-eluting stents.

Key Words: bare-metal stents • drug-eluting stents • sirolimus-eluting stents • paclitaxel-eluting stents • zotarolimus-eluting stents • everolimus-eluting stents • stent thrombosis • restenosis • diabetes • cost-effectiveness • stent fracture • left main disease • myocardial infarction • saphenous vein grafts • clopidogrel

Abbreviations and Acronyms   ACS = acute coronary syndrome   BMS = bare-metal stent(s)   CABG = coronary artery bypass grafting   CAD = coronary artery disease   CI = confidence interval   CoCr = cobalt chromium   CTO = chronic total occlusion   DAPT = dual antiplatelet therapy   DES = drug-eluting stent(s)   EES = everolimus-eluting stent(s)   FDA = Food and Drug Administration   HR = hazard ratio   ISA = incomplete stent apposition   ISR = in-stent restenosis   IVUS = intravascular ultrasound   MACE = major adverse cardiovascular events   MI = myocardial infarction   MVD = multivessel disease   PCI = percutaneous coronary intervention   PES = paclitaxel-eluting stent(s)   POBA = plain old balloon angioplasty   RR = relative risk   SES = sirolimus-eluting stent(s)   ST = stent thrombosis   STEMI = ST-segment elevation myocardial infarction   SVG = saphenous vein graft   TLR = target lesion revascularization   TVR = target vessel revascularization   UPLMS = unprotected left main stem   ZES = zotarolimus-eluting stent(s)

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