The comparative safety of bare-metal and drug-eluting intracoronary stents

Abstract

Bare-metal stents were a significant advance over percutaneous transluminal coronary angioplasty in the treatment of atherosclerotic coronary artery disease. However, bare-metal stents are plagued by a restenosis rate of approximately 30%. First-generation drug-eluting stents greatly reduce restenosis but are associated with a troublesome persistence of late thrombotic events. Stent thrombosis is a devastating clinical event, with high mortality rates. While the superior efficacy of drug-eluting stents is unquestioned, the relative safety of bare-metal and drug-eluting stents has been hotly debated. This article will address the safety of bare-metal and drug-eluting stents, and will describe current and future stent systems that promise to maintain current efficacy, while reducing thrombosis risk even further.

Keywords::

• bare-metal stent
• drug-eluting stent
• endothelialization
• hypersensitivity
• safety
• stent fracture
• stent thrombosis

Financial & competing interests disclosure

RJ Applegate is a member of the Abbott Vascular advisory board, and has received consulting fees from Abbott Vascular. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Notes

Data from [19].

DAPT: Dual antiplatelet therapy.

MI: Myocardial infarction; ST: Stent thrombosis.

Data taken from [19].