Coronary stents and vascular scaffolds: Development, innovations and long-term results

Since Grüntzig’s first balloon angioplasty in 1977, 3 innovations have dramatically improved short and long-term outcomes: the introduction of coronary stents to treat angioplasty-induced vascular dissection, development of drug-eluting stents to prevent in-stent restenosis and dual platelet inhibition for prevention of acute and subacute stent thrombosis. Further advances in stent design with reduced strut thickness and stronger alloys (i.e. cobalt-chromium and platinum-chromium), bioresorbable polymers and novel anti-proliferative drugs have contributed to the long-term success. With the introduction of bioresorbable vascular scaffolds the disadvantages of metal-based permanent stents, e. g. difficulty of subsequent bypass surgery and artefacts during computed tomography (CT) and magnetic resonance imaging (MRI) are increasingly being resolved. The indications for interventional versus surgical revascularization must continually be redefined in the guidelines based on new techniques and study evidence of innovative interventional methods and stent systems. © 2016, Springer-Verlag Berlin Heidelberg.