Mechanisms of vascular injury from drug-eluting stents

The mechanisms of vascular injury from drug-eluting stents are a result of the dynamic interaction of stent, polymer and drug with the underlying vessel wall. These devices may be associated with a significant delay in arterial healing characterized by persistent fibrin deposition, inflammation and impaired re-endothelialization which provide the pathobiologic underpinnings for late stent thrombosis seen months to years after implantation. Other factors associated with delayed or incomplete healing include penetration of the plaque necrotic core, strut mal-apposition, overlapping struts or excessive stent length.

Section editor:Joel Linden – Department of Medicine, University of Virginia, Charlottesville, VA, USA