title: The need for stent-lesion matching to optimize outcomes of intracoronary stent implantation.
abstract: Intracoronary stents have markedly improved the outcomes of catheter-based coronary interventions. Intracoronary stent implantation rates of over 90% during coronary angioplasty are common. Stent implantations are associated with a small but statistically significant number of adverse outcomes including restenosis, thrombosis, strut malapposition, incomplete strut endothelialization, and various types of stenting failure. Better matching of biomechanical properties of stents and lesions could further improve the clinical outcome of intracoronary stenting. Thus, in this article, we assess the need for advanced intracoronary stent-lesion matching. We reviewed the data on biomechanics of coronary stents and lesions to develop knowledge-based rationale for optimum intracoronary stent selection. The available technical information on marketed intracoronary stents and the current understanding of the biomechanical properties of coronary lesions at rest and under stress are limited, preventing the development of knowledge-based rationale for optimum intracoronary stent selection at present. Development of knowledge-based selection of intracoronary stents requires standardization of mechanical stent testing, communication of the nonproprietary technical data on stents by the industry and dedicated research into procedural stent-lesion interactions.
authors.affiliation: Department of Cardiology and Angiology, Hospitals and Clinics Bitterfeld-Wolfen, Bitterfeld, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Lanzer
authors.forename: Gerhard
authors.initials: G
authors.lastname: Strupp
authors.forename: Wolfram
authors.initials: W
authors.lastname: Schmidt
authors.forename: L D Timmie
authors.initials: LD
authors.lastname: Topoleski
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation* / Q000379:methods; D001696:Biomechanical Phenomena; D001794:Blood Pressure; D002404:Catheterization; D003331:Coronary Vessels / Q000601:surgery*; D004548:Elasticity; D004867:Equipment Design; D006801:Humans; D008422:Materials Testing; D011108:Polymers / Q000737:chemistry; D015607:Stents; D013927:Thrombosis; D016896:Treatment Outcome
chemical_list: D011108:Polymers
keywords: biomechanics; coronary artery lesions; intracoronary stenting; lesion matching; stent