Practical Clinical Evaluation of Stents (original) (raw)

1998, Journal of Interventional Cardiology

This article discusses the clinical issues pertaining to an optimal stenting result and analyzes relevant stent structures and functions. There are five components of optimal stenting: favorable clinical features, easy stent deliver?/, ideal scaffolding, low stent thrombosis, and low restenosis. In straightforward cases, such as stenting in the mid-right coronary artery with a straight proximal segment, procedural success can be achieved with any stent. In vessels with curved, tortuous proximal segments, a highly flexible stem is needed for a smooth and successful delivety For ostial, protected lefi main, or aortoanastomotic lesions, stents with suficient radial strength and good visibility are needed. The two major concerns of an interventional cardiologist choosing a stent are excellent trackability for fast delivery and low long-term restenosis rate. In all situations, the procedural success depends on the operator's manual dexterity, experience with a particular stent design, and critical evaluation of different structural stent features to maximize benefits. Any new stent with high longitudinalflexibility, excellent scaffolding and radial strength, adequate radiopacity, complete deployment after one inflation, and that is easily recrossed and provides a good symmetrical conduit for a smooth coronaryjlow resulting in little tendenq for thrombosis or restenosis would be today's stent of choice.