title: New-Generation Coronary Stents: Current Data and Future Directions.
abstract: OBJECTIVE
  Drug-eluting stents are the mainstay in the treatment of coronary artery disease using percutaneous coronary intervention. Innovations developed to overcome the limitations of prior generations of stents include biodegradable polymer stents, drug-eluting stents without a polymer, and bioabsorbable scaffolds. Our review briefly discusses the clinical profiles of first- and second-generation coronary stents, and provides an up-to-date overview of design, technology, and clinical safety and efficacy profiles of newer generation coronary stents discussing the relevant clinical trials in this rapidly evolving area of interventional cardiology.
  
  
  RESULTS
  Drug-eluting stents have previously been shown to be superior to bare metal stents. Second-generation everolimus-eluting stents have proven to have superior outcomes compared with first-generation paclitaxel- and sirolimus-eluting stents, and the second-generation zotarolimus-eluting stents appear to be similar to the everolimus-eluting stents, though with a lesser degree of evidence. Stents with biodegradable polymers have not been shown to be superior to everolimus-eluting stents. Bioabsorbable scaffolds have not demonstrated better outcomes than current standard treatment with second-generation drug-eluting stents but have showed a concerning signal of late and very late stent thrombosis. Everolimus-eluting stents have the most favorable outcomes in terms of safety as well as efficacy in patients undergoing percutaneous coronary intervention. Newer innovations such as biodegradable polymers and bioabsorbable scaffolds lack clinical data to replace second-generation drug-eluting stents as standard of care.
authors.affiliation: Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, TX, USA.|Weill Cornell Medical College, New York, NY, USA.|Safety, Quality, Informatics and Leadership Program, 2016-17, Harvard Medical School, Boston, MA, USA.
authors.forename: Ankur
authors.initials: A
authors.lastname: Kalra
authors.affiliation: Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, TX, USA.
authors.forename: Hasan
authors.initials: H
authors.lastname: Rehman
authors.affiliation: New York Medical College, White Plains, NY, USA.
authors.forename: Sahil
authors.initials: S
authors.lastname: Khera
authors.affiliation: Department of Internal Medicine, Monmouth Medical Center, Long Branch, NJ, USA.
authors.forename: Braghadheeswar
authors.initials: B
authors.lastname: Thyagarajan
authors.affiliation: Brigham and Women's Heart and Vascular Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Deepak L
authors.initials: DL
authors.lastname: Bhatt
authors.affiliation: Houston Methodist DeBakey Heart and Vascular Center, Houston Methodist Hospital, Houston, TX, USA.|Weill Cornell Medical College, New York, NY, USA.
authors.forename: Neal S
authors.initials: NS
authors.lastname: Kleiman
authors.affiliation: The Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA. ryeh@bidmc.harvard.edu.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Yeh
mesh_terms: D020341:Absorbable Implants / Q000639:trends; D002986:Clinical Trials as Topic; D003324:Coronary Artery Disease / Q000628:therapy*; D054855:Drug-Eluting Stents / Q000639:trends; D005544:Forecasting; D006801:Humans; D062645:Percutaneous Coronary Intervention / Q000295:instrumentation* / Q000639:trends; D011474:Prosthesis Design / Q000639:trends; D015607:Stents / Q000639:trends; D054457:Tissue Scaffolds / Q000639:trends
keywords: Angioplasty; BVS; Bioabsorbable stents; Newer generation coronary stents; PCI