Drug-eluting stent implantation for coronary artery disease: current stents and a comparison with bypass surgery

Percutaneous coronary intervention (PCI) with bare-metal stents (BMS) has been performed increasingly ever since its introduction in the late 1970s. BMS have been replaced by drug-eluting stents (DES), and many interventional cardiologists consider this as a breakthrough therapy that might compete with coronary artery bypass grafting (CABG) as the standard treatment for coronary artery disease. Several DES are currently used and elute different agents. This review described what these agents are and provides an overview regarding the outcomes and associated adverse events. More importantly, this review compares outcomes of PCI with DES to CABG for patients with left anterior descending coronary artery involvement, left main involvement, or multivessel disease.

► Drug-eluting stents are superior to bare-metal stents in reducing late lumen-loss. ► Several stents show satisfactory outcomes, but a superior stent has not yet been identified. ► Outcomes after stenting and CABG have converged significantly over the past two decades. ► CABG remains the standard of care for patients with proximal LAD or LM coronary artery involvement.