Design and Clinical Applications of Intracoronary Stents in Coronary Revascularization-An Updated Review

Abstract

Background: Coronary artery disease remains a leading cause of morbidity and mortality worldwide. Percutaneous  coronary intervention with stent implantation has become a primary revascularization strategy. Continuous evolution  of stent technology has aimed to reduce restenosis, thrombosis, and procedural complications while improving long term vascular outcomes. Aim: This review aimed to analyze the evolution, structure, indications, preparation, and  procedural considerations of coronary stents, with emphasis on technological advancements and clinical implications  in interventional cardiology. Methods: A structured narrative synthesis of coronary stent literature was conducted,  focusing on historical development, device engineering, pharmacological coatings, procedural techniques, and clinical  trial evidence. Key studies evaluating bare-metal stents, first-generation drug-eluting stents, second-generation  platforms, and emerging technologies were reviewed. Results: Findings demonstrate significant improvement in  clinical outcomes with drug-eluting stents compared with bare-metal stents, particularly in reducing in-stent restenosis  and target vessel revascularization. Second-generation stents showed further reduction in stent thrombosis and  improved biocompatibility. Newer technologies, including bioresorbable scaffolds, polymer-free stents, and ultra-thin  strut designs, offer promising advancements but require further long-term validation. Procedural success is strongly  influenced by lesion preparation, imaging guidance, and individualized patient selection. Conclusion: Coronary stent  technology continues to evolve toward safer, more effective, and more biologically compatible systems. Integration  of mechanical innovation and pharmacological modulation has transformed coronary intervention outcomes, although  ongoing refinement is required to address complex lesions and long-term vascular responses.