Clinical benefits of drug-eluting stents: results from RAVEL and beyond

Abstract

Drug-eluting stents have revolutionized interventional cardiology by incorporating drug and device therapy to reduce rates of restenosis. Early trials have addressed the safety and efficacy of drug-eluting stents. Recent studies have evaluated the use of drug-eluting stents in high-risk populations that were not initially randomized in the early trials. These stents have shown promising outcomes in diabetes, in-stent restenosis, and multivessel disease. The clinical benefits of these stents have been systematically quantified across multiple trials; however, there is a growing debate regarding restenosis and late-stent thrombosis after implantation. Given the expanding indications for drug-eluting stents, the American Heart Association identified it as one of the Top 10 Research Advances for 2005. The purpose of this article is to summarize the current debate surrounding late-stent thrombosis, examine the evidence from leading stent trials, and outline the clinical benefits of drug-eluting stents.