drugelutingStents

Drug-eluting stents (DES) are intravascular devices used during percutaneous coronary intervention to treat narrowed or occluded coronary arteries. DES are metal stents coated with a polymer that releases an antiproliferative drug over time to suppress neointimal hyperplasia, thereby reducing restenosis compared with bare-metal stents.

Most DES use drugs such as sirolimus, everolimus, zotarolimus, paclitaxel, or analogs, delivered from a durable or biodegradable polymer. The release period ranges from weeks to months, and newer designs aim to minimize inflammation and late tissue hypersensitivity. In addition to the drug, stent platforms differ in strut thickness, surface finish, and whether the polymer remains permanently or degrades.

In clinical practice, DES have largely replaced bare-metal stents for many patients undergoing coronary angioplasty because of lower rates of repeat revascularization. However, DES carry a risk of late stent thrombosis, particularly if antiplatelet therapy is interrupted. This has led to recommendations for a defined duration of dual antiplatelet therapy (DAPT) after implantation, tailored to patient risk.

Variants include DES with biodegradable polymers, polymer-free designs, and bioresorbable vascular scaffolds, which were pursued to reduce long-term complications but have faced mixed results in trials. Overall, DES remain a central technology in the treatment of coronary artery disease requiring stenting, with ongoing development to improve safety and long-term outcomes.