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The Reduction in Total Mortality with Drug-Eluting Stents: Does Emperor has New Clothes?

Over last 3 decades, percutaneous coronary interventions (PCI) has transformed management of obstructive coronary artery disease (CAD). Commenced with balloon dilation i.e. plain old balloon angioplasty (POBA) of severe obstructive CAD lesions, gradually evolved into stenting started with bare-metal stents (BMS), initially first-generation (stain-less steel) and now contemporary second-generation BMS (cobalt-chromium with thinner struts). BMS was rapidly superseded by drugeluting stents (DES); at first with first-generation (paclitaxeleluting, taxus; and sirolimus-eluting, cypher) now with secondgeneration (zotarolimus-eluting, endeavor; and everolimuseluting, xience) and with ongoing refinements thirdgeneration drug-eluting stents (with biodegradable polymers, polymer-free and biodegradable stents on the basis of poly-Llactide or magnesium) are undergoing trials and many are available for use in contemporary practice.


Abdullah Mohammed Shehab, Neelesh Gupta, and Sukri Saliba Sukri Mushahawar

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