The Evolution of Coronary Stents: A Brief Review

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The Evolution of Coronary Stents: A Brief Review Trevor Simard, MD, Benjamin Hibbert, MD, PhD, F. Daniel Ramirez, MD, Michael Froeschl, MD, Yong-Xiang Chen, MD, PhD, Edward R. O'Brien, MD Canadian Journal of Cardiology Volume 30, Issue 1, Pages 35-45 (January 2014) DOI: 10.1016/j.cjca.2013.09.012 Copyright © 2014 Canadian Cardiovascular Society Terms and Conditions

Figure 1 Zotarolimus (Endeavor)-eluting stent. (A) Undeployed stent attached to a balloon-tipped catheter for transarterial delivery. (B) Expanded stent after inflation of balloon tip on catheter assembly. (C) Removal of the deflated balloon-tipped catheter assembly from within the expanded stent. (D) Deployed stent. Canadian Journal of Cardiology 2014 30, 35-45DOI: (10.1016/j.cjca.2013.09.012) Copyright © 2014 Canadian Cardiovascular Society Terms and Conditions

Figure 2 Progression of in-stent restenosis. Cross-sectional and longitudinal views of artery depicting chronological progression of in-stent restenosis. (A) Obstructive atheromatous plaque causing flow-limiting stenosis of the arterial lumen with reduced luminal diameter. (B) After percutaneous endoluminal stenting which restores the native vessel diameter by compressing the atheromatous plaque into the vessel wall with resultant denudation of the endothelial layer. (C) In-stent restenosis after inappropriate neointimal hyperplasia in response to percutaneous stent insertion resulting in recurrence of flow-limiting stenosis. Canadian Journal of Cardiology 2014 30, 35-45DOI: (10.1016/j.cjca.2013.09.012) Copyright © 2014 Canadian Cardiovascular Society Terms and Conditions

Figure 3 Stent re-endothelialization. (A) Overview of embedded stent displaying areas of completely re-endothelialized stent and exposed struts. (B) Completely re-endothelialized segment. (C) Close-up of single stent strut displaying partial re-endothelialization. Canadian Journal of Cardiology 2014 30, 35-45DOI: (10.1016/j.cjca.2013.09.012) Copyright © 2014 Canadian Cardiovascular Society Terms and Conditions

Figure 4 Drug-filled stent. Note sinusoidal strut design with laser-drilled elution ports on exterior aspects of the stent providing access to the drug-filled core. Reproduced with permission from Medtronic. Canadian Journal of Cardiology 2014 30, 35-45DOI: (10.1016/j.cjca.2013.09.012) Copyright © 2014 Canadian Cardiovascular Society Terms and Conditions