Drug-eluting stents: Are they still the answer?

Drug-eluting stents have profoundly impacted the interventional cardiology field. Their efficacy against the smooth muscle hyperplasia responsible for in-stent restenosis has significantly altered practice patterns and patient selection for percutaneous and surgical revascularization. However, their potent antiproliferative properties and polymer coatings delay the healing process of the arterial wall and appear to prolong the duration of stent thrombogenicity. The actual clinical impact of this effect is controversial. However, the sequelae of stent thrombosis can be catastrophic and have driven much recent discussion on this subject. This article attempts to provide perspective on the benefits and limitations of these devices so that their use achieves maximum benefit and lowest risk.