Stenting has revolutionized Interventional
Cardiology resulting in higher (99%) acute success rate and lower rates
of restenosis (renarrowing). Interventional Cardiologists at BIDMC helped
develop and studies these procedures and pioneered the use of stents
(implanting the first stent in coronary arteries in 1988). Stents come
in different designs and configurations including slotted tubes, coils,
meshs,
.. Stents are delivered while collapsed and are then deployed
using a delivery balloon and may be postdilated to achieve a perfect
result. Stents remains in the artery permanently, holding it open, and
preventing restenosis (and remodeling). Stents are used in 70-80% of
interventional procedures due to their reliability and predictable results
and their beneficial effects on restenosis. Reclosure (restenosis) is
also a problem with stenting procedure, but at a rate lower than baloon
angioplasty alone. Drug eluting stents or medicated stents have reduced risk of restenosis and are overwhelmingly used in revascularization. A problem unique to stents is acute of subacute thrombosis
of the artery after successful stenting. However, this risk is reduced
to <1% by antiplatelet agents (Aspirin and Plavix) and good stenting
technique. Adequate stent deployment and expansion (often confirmed vy intravascular Ultrasound) achieving near perfect
acute results are crucial to reducing the risk of thrombosis and the
delayed risk of restenosis.