Stenting of coronary arteries: Has a modern Pandora's box been opened?

Patrick W. Serruys*, Bradley H. Strauss, Heleen M. van Beusekom, Willem J. van der Giessen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

90 Citations (Scopus)

Abstract

Interventional cardiology has recently witnessed the growth of several alternatives to percutaneous transluminal angioplasty, including coronary stenting. Although stenting appears to be useful in treating abrupt closure after coronary angioplasty its effectiveness in limiting the complex processes responsible for late restenosis is much less certain. Pathologic examination of stented human saphenous bypass grafts shows extensive deposits of platelets, fibrin and leukocytes along the stent wires within the 1st week and formation of a neointima of variable thickness after 3 months without evidence of foreign body reaction. The long-term effects of continuous barotrauma induced by the expanded stent remain unknown. It is difficult to assess the relative merits of the new devices, but stenting has several theoretic advantages. It seems less disruptive to the underlying architecture of the vessel wall and enjoys favorable theoretic and effective expansion ratios. Widespread clinical acceptance for stenting will depead on demonstrating that its safety, efficacy and cost efficiency are superior to those of balloon angioplasty.

Original languageEnglish
Pages (from-to)143-154
Number of pages12
JournalJournal of the American College of Cardiology
Volume17
Issue number6 SUPPL. 2
DOIs
Publication statusPublished - May 1991

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