- Juan Luis Gutiérrez-Chico, MD, PhDBundeswehrzentralkrankenhaus (Federal Armed Forces Central Hospital), Koblenz, Germany
- Myung Ho Jeong, MD, PhDDepartment of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
Drug-eluting stents (DES) have likely been the most prominent game changer in coronary revascularization since the development of percutaneous coronary interventions. They have drastically reduced the restenosis rates of bare metal stents (BMS), expanded the indication for percutaneous revascularization to the most challenging scenarios, and currently compete with coronary bypass graft surgery for the treatment of coronary heart disease.
Despite their promising beginning, in 2006 DES were in the spotlight due to several scientific studies which reported an increased risk of stent thrombosis. This inspired an unprecedented wave of technological innovation, aimed at understanding and ultimately preventing the life-threatening phenomenon of thrombosis after DES implantation. An entire portfolio of innovative and technologic improvements including biocompatible or biodegradable polymers, polymer-free stents, refined kynetics of drug-release, and reservoirs, were introduced to overcome these concerns and deliver optimal clinical outcomes. The so called "2nd generation DES" have outperformed not only their precursos (BMS), but also their potential successors (bioresorbable scaffolds). Even when the future of coronary interventions seemed to tilt toward bioresorbable devices and restoration of vasomotion, the cooperation between cardiologists and engineers resulted in metallic DES designed to preserve arterial vasomotion; demonstrating the versatility of these devices.
The current special edition of Reviews in Cardiovascular Medicine, entitled "New advances in drug eluting stents" aims to summarise the most relevant technological improvements in the design of DES that have ultimately contributed to making DES as the highest standard of care for percutaneous revascularization for most clinical scenarios. A call for original studies or state-of-the-art reviews has been done, in order to select the best articles for this topic.
Prof. Juan Luis Gutiérrez-Chico and Prof. Myung Ho Jeong
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