Coronary artery stents have created the revolutionary field of interventional cardiology. Since their conception in 1964, to the first coronary angioplasty performed in 1977, multidisciplinary work has made what seemed like incredible and outlandish minimally invasive reopening of coronary occlusion into a commonplace mainstay of treatment, reducing mortality from cardiovascular disease globally.
Since the first stent implantation in 1986 the past 35 years of research have seen iterative progress. We have witnessed ever-evolving stent design. Drug-eluting stents resulted in a reduction in post-implantation restenosis and thrombosis previously seen with bare metal stents. Stent platforms have offered improved deliverability, circumferential strength and thinner stent struts, such that we are now able to offer tailored stent delivery to the most tortuous and bifurcated of vessels, in territories that were once seen as insurmountable. Bioresorbable stents also promised a further revolution, with hopes of complete elution of drug, resorption of the delivery mechanism, and reduced inflammatory response, but ultimately underwhelming and inferior results. As drug eluting balloons offer an alternative goal of restoring lumen patency through dilatation and targeted drug delivery, in the absence of the physical scaffold, we review the progress of percutaneous coronary intervention over the lifetime of our speciality and look towards future developments and alternatives that may supersede the drug eluting stent hegemony.
Conflict of Interest None
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