Optimising coronary stent design: a multidisciplinary challenge

The use of percutaneous coronary intervention (PCI) for the treatment of coronary heart disease has expanded greatly in recent decades. This growth has been fuelled by a series of technological advances, most notably with the first use of bare metal stents and the subsequent introduction of drug-eluting stents (DES). Although DESs are now the treatment of choice in most PCI procedures, significant opportunities to enhance their design remain.
The three key components of a successful DES are the stent, drug(s), and the coating technology, which provides controlled release of the drug(s). The latest stents employ novel geometric designs that, when taken together with the use of advanced metal alloys, have enabled stent performance to be improved. These stents also now feature enhanced coating technologies, driven by the use of polymers with enhanced biocompatibility, innovations in biodegradable polymers and by the recent introduction of polymer-free approaches to drug delivery. However, the use of different drugs has been more limited, with even the most recent generation of DESs incorporating drugs with similar profiles of action to those used in first generation devices.
This talk will discuss some of the key remaining challenges in coronary stent design. It will consider the potential role that novel drugs and biomaterials, non-invasive monitoring technologies and in silico modelling, have to play in addressing these challenges. The multidisciplinary nature of this task will be demonstrated through the use of recent case studies from my own research in this area.