Endovascular drug-delivery and drug-elution systems

Stents have changed medicine and the treatment of obstructive vascular disease. Technology advancement and outcomes of numerous clinical trials have led to development of different generations of stents and other novel endovascular implants. Herewith, we briefly discuss the evolution of coronary intervention from balloon angioplasty to contemporary alternatives such as second-generation drug-eluting stents, bioresorbable scaffolds, drug-eluting balloons, and polymer-free stents. We briefly present clinical outcomes, solved/remaining challenges for each category, and accumulating evidence on effectiveness and safety of emerging therapies. With computational modeling playing an ever-increasing role in designing medical devices, we also review the impact of such models on understanding and optimizing drug delivery in stents. Interventional cardiology has made great strides because technological innovation has marched in lock step with advances in understanding the basic science of vascular repair. The continued evolution of endovascular therapies will rely on retaining this link between mechanistic insight and enlightened technical development.