Benefits of and Safety Concerns Associated with Drug-eluting Coronary Stents

Scot Garg; Patrick Serruys


Expert Rev Cardiovasc Ther. 2010;8(3):449-470. 

In This Article

Abstract and Introduction


Drug-eluting coronary stents are being used with increasing frequency in patients undergoing percutaneous coronary intervention. Although these stents have shown remarkably low rates of restenosis compared with their predecessors, there have been increasing concerns lately regarding their safety. Extensive data have been published that demonstrate a higher risk of very late stent thrombosis with drug-eluting stents; however, this has not had any impact on long-term mortality or the risk of myocardial infarction when compared with bare-metal stents. Their overall net clinical benefit therefore still favors their use. Recent research has led to a greater understanding of the multifactorial cause of stent thrombosis, which has enabled measures to be taken to reduce an individual patient's risk. In the future, new stent designs and new antiplatelet agents may help to reduce this risk further.


Stent thrombosis (ST) is fortunately rare, but in recent years it has emerged as a major safety concern with the use of coronary stents.[1–7] The increasing use of percutaneous coronary intervention (PCI) to treat coronary artery disease, and high overall drug-eluting stent (DES) usage in PCI procedures,[8] ensures that these safety concerns have important far-reaching implications, and warrant careful evaluation and critical review. This article will review the safety concerns and the benefits of DES, the causes of ST and the clinical impact of this condition.


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