title: Bare Metal Stents Versus Drug Eluting Stents: Where Do We Stand in 2015?
abstract: The development of bare metal stent (BMS) was a major advancement over plain old balloon angioplasty (POBA) in the management of symptomatic coronary artery disease. BMS prevented restenosis by attenuating early arterial recoil and contraction; both seen commonly after POBA. However, the rate of clinically indicated target lesion repeat revascularization due to a process of in-stent restenosis (ISR) at 1 year remained relatively high (10 to 20 %), often due to excessive neointimal growth (Fischman et al. N Engl J Med. 331:496, 1994; Serruys et al. N Engl J Med. 331:489, 1994; Cutlip et al. J Am Coll Cardiol 40:2082, 2002). Stents with drug elution technology (DES) were developed to reduce the relatively high rate of ISR and subsequent repeat revascularization seen with BMS. Clinical trials have confirmed a reduction of as much as 50 to 70 % in target lesion revascularization by DES compared to BMS. These findings have led to the preferential use of DES in the majority of percutaneous coronary intervention (PCI). However, as DES require a longer period of dual antiplatelet therapy (DAPT) to prevent stent thrombosis, DES are not appropriate for all patients.
authors.affiliation: Department of Cardiology, North Shore LIJ Health System, Hofstra - North Shore LIJ School of Medicine, 300 Community Drive, Manhasset, NY, 11030, USA, PMeraj@nshs.edu.
authors.forename: Perwaiz M
authors.initials: PM
authors.lastname: Meraj
authors.forename: Rajiv
authors.initials: R
authors.lastname: Jauhar
authors.forename: Avneet
authors.initials: A
authors.lastname: Singh