EVOLUTION OF CORONARY STENTS: FROM EARLY EXPERIMENTS TO MODERN TECHNOLOGIES

Highlights

This review presents a systematic overview of scientific achievements in the development and use of coronary stents. It includes an analysis of key studies addressing various aspects of their performance. The article examines existing generations of coronary stents, materials used in their manufacture, design features, and also describes the latest advancements in this field.

Abstract

To trace the evolution of coronary stents and identify promising directions in the development of endovascular surgery.An analytical literature review was conducted, including results from major randomized clinical trials and meta-analyses published in leading cardiology journals between 1994 and 2025.The introduction of coronary stent implantation technology reduced the incidence of thrombosis and the need for repeat revascularization compared to balloon angioplasty. However, a high risk of restenosis limited their use. The emergence of drug-eluting stents in the 2000s led to a sharp decrease in neointimal hyperplasia and repeat interventions but was associated with a risk of late thrombosis. Modern generations of stents demonstrate improved efficacy and safety. Bioresorbable stents were an innovative development but failed to show superiority in large randomized trials. Currently, stents incorporating novel anti-inflammatory agents (such as colchicine) are under development. The evolution of coronary stents reflects the pursuit of an optimal biocompatible device that induces minimal inflammatory response, promotes rapid vascular wall healing, and eliminates the need for prolonged dual antiplatelet therapy.

A literature search was conducted in the PubMed electronic database for publications from 1994 to 2025. The following keywords were used: «coronary stent», «bare metal stent», «drug-eluting stent», «polymer-free», and «bioresorbable scaffold». The review included clinical studies, systematic reviews, meta-analyses, randomized controlled trials, and comparative studies relevant to the topic of analysis.

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